Jacob Bickels's research while affiliated with Hillel Yaffe Medical Center and other places

Publications (132)

Article
: Soft-tissue sarcomas (STS) in adults comprise a heterogeneous group of tumors of mesenchymal origin that share similar biological patterns of local tumor growth and metastatic dissemination. ➤: The judicious use of imaging studies, biopsy techniques, and pathological evaluations is essential for accurate diagnosis and for planning treatment st...
Article
Objective: Sarcoma arising in the region of the buttocks is a rare entity and therefore no consensus regarding management exists in the literature. Methods: 16 patients diagnosed with localized, non-metastatic primary soft-tissue sarcoma (STS) in the buttock area, who were consecutively treated between 2005 and 2013, were retrospectively evaluat...
Article
Excision of the proximal femur for tumour with prosthetic reconstruction using a bipolar femoral head places a considerable load on the unreplaced acetabulum. We retrospectively reviewed the changes which occur around the affected hip joint by evaluating the post-operative radiographs of 65 consecutive patients who underwent proximal prosthetic art...
Article
Full-text available
The article describes a unique clinical case of multifocal synchronous osteosarcoma patient 10 years old with the defeat of the right femur and humerus identified in a clinic in Israel in 2014. The patient was conducted a combined treatment including arthroplasty. At the time of this writing, the patient is alive without evidence of disease manifes...
Book
Operative Techniques in Orthopaedic Surgical Oncology provides full-color, step-by-step explanations of all operative procedures in orthopaedic oncology. This text contains the chapters from the oncology section in Sam W. Wiesel's Operative Techniques in Orthopaedic Surgery. Written by experts from leading institutions around the world, this superb...
Article
Introduction Endoprosthetic reconstruction is considered the mainstay of limb salvage in periarticular bone tumours. However, this procedure has limited durability especially when performed in young patients. The free fibula head flap including the proximal articular surface represents one option for hemiarthroplasty reconstruction. Patients and m...
Article
Neoadjuvant chemotherapy for osteosarcoma is the standard of care, but there is still confusion regarding the best chemotherapy regimen and the optimal intensity. This retrospective study intends to evaluate whether there is a clear correlation between the chemotherapy dose intensity (DI) and the percentage of tumor necrosis, the risk of tumor recu...
Chapter
Bone tumours are relatively rare and their diagnosis requires a staged multi-disciplinary approach using clinical, radiographic, and histological analyses, when required. Patient’s history and plain radiographs remain the key factors in establishing the correct diagnosis in the majority of these cases. Anatomical location of the lesion, pattern of...
Article
Reconstruction of the posterior neck is one of the rarer procedures performed by plastic surgeons; we used free flaps for the closure of defects in this area in six cases over the past 4 years. Six patients were located requiring posterior neck reconstruction between the years 2007 and 2013. Five of these patients required reconstruction due to onc...
Article
Distal tibial tumor ablation results in combined soft tissue and bone defect that involves the ankle joint. This area is unique and problematic because it combines low caliber limb size, relatively soft tissue deficiency, suboptimal bone and soft tissue healing ability, and the need to sustain increased mechanical loads. The management is difficult...
Article
Objective: Adjuvant radiation therapy (RT) is an essential part of combined limb-sparing treatment of soft-tissue sarcoma (STS). Elderly or medically unfit patients often have difficulty in completing 6-7 weeks of standard fractionated daily treatment. Our aim was to evaluate the efficacy of a hypofractionated adjuvant approach with RT for STS in...
Article
Objective: Chondrosarcomas (CS) represent a heterogeneous group of rare sarcomas, poorly responsive to chemotherapy or radiotherapy. When local therapies in recurrent or metastatic disease are exhausted, chemotherapy plays a marginal role. Different molecular pathways have been shown to be activated in CS. In this retrospective study, we summarize...
Conference Paper
Reconstruction of large bony gaps of the femur poses a surgical challenge, the most common etiology being primary long bone malignancy. In defects larger than 4 cm reconstruction, using a a vascularized fibular graft in adjunct to an autograft or bony allograft, is indicated. We would like to present our experience with this procedure and the lesso...
Article
Ketamine induces a short-term effect on postoperative pain when administered intravenously immediately before or during acute pain. Repeated administration of low-dose ketamine may induce long-term pain relief in chronic pain syndromes. The aim of our study was to determine whether ketamine's effect on acute postoperative pain could be enhanced and...
Article
Full-text available
Background: Pleomorphic Sarcoma is the most common histologic subtype of high grade soft tissue sarcoma involving the extremities. Methods: This retrospective study analyzed 135 patients presenting with primary Pleomorphic Sarcomas which were treated at a single referral institute between 1980 and 2006. Data was collected from an institutional data...
Article
Among the objectives in writing the current chapter were the curiosity and the interest in allocating the sites and routes of migration of the reservoirs of the mesenchymal precartilaginous stem cells of the developing limbs in health and in disease. We chose to emphasize the events believed to initiate in these regions of stem cells, which may lea...
Article
Full-text available
Most children today with bone sarcomas undergo limb-sparing surgery. When treating children younger than 12 years of age, the result is significant limb length discrepancy (LLD). One of the solutions is the use of an expandable endoprosthesis. A retrospective analysis of 38 skeletally immature patients with bone sarcoma of the lower limb in whom di...
Article
Background: Extracompartmental soft-tissue sarcomas of the sartorial canal grow in a virtual space in close proximity to the superficial femoral artery and vein and thus require a complex resection. This study was designed to assess the presentation pattern, preoperative evaluation and oncologic and functional outcomes. Methods: We retrospectively...
Article
Metastatic bone disease is a major contributor to the deterioration of the quality of life of patients with cancer; it causes pain, impending and actual pathological fractures, and loss of function and may also be associated with considerable metabolic alterations. Operative treatment may be required for an impending or existing fracture and intrac...
Article
Extra-compartmental soft tissue sarcomas may grow in virtual spaces in close proximity to major neurovascular structures and thus, require a complex resection. We analyzed the general principles by which these resections are planned. We retrospectively analyzed 53 patients with sarcomas located in the femoral triangle (15), sartorial canal (16), an...
Article
This summary of a single center's extensive cumulative experience in bone tumor cryosurgery assesses the long-term outcome of bone conservation surgery in which adjuvant cryosurgery plays a pivotal role. We performed 440 cryosurgical procedures between January 1988 and December 2002. Two-thirds of the series comprised a variety of primary benign-ag...
Article
Background: Postoperative pain in patients with bone and soft tissue cancer is different from that of other surgical patients due to the severity of the pain generated during surgery and because many of them have already been in pain preoperatively. The search for optimal intravenous pharmacologic management for this population is an ongoing one....
Article
Distal femoral resection and endoprosthetic reconstruction are sometimes associated with flap necrosis and inadequate soft tissue coverage. We evaluated the anterior popliteal surgical approach, which was designed to reduce those complications by using a posteromedial myocutaneous flap based upon the vastus medialis. A retrospective analysis of 46...
Article
Simple resection of diffuse pigmented villonodular synovitis of the ankle joint is associated with local recurrence rates as high as 50%. Thus, adjuvant treatment modalities, such as radiation or intra-articular isotope injection, are sometimes used after tumor resection. Our initial and highly satisfactory experience with the injection of radioact...
Article
Full-text available
The incidence of musculoskeletal tumors during pregnancy is very low. The aim of this study was to summarize our experience in treating a large cohort of pregnant patients diagnosed with these rare tumors. Women diagnosed with musculoskeletal tumors during pregnancy or immediately after delivery were identified retrospectively in our database betwe...
Article
Full-text available
Synovial sarcoma (SS) of an extremity or trunk is relatively rare and is approached by limb sparing surgery (LSS), radiation therapy (RT) and chemotherapy. We conducted a retrospective analysis of the clinical and histopathological data of 73 patients with proven SS. At a median follow-up time of 6 years, local recurrence was seen in 17.8 and syste...
Article
The authors describe the surgical technique and functional results of extensor mechanism reconstruction after major resections of soft-tissue tumors from the anterior compartment of the thigh. Between 1983 and 2003, 78 patients with soft-tissue sarcomas of the anterior compartment of the thigh were operated on at the authors' institution. Sixteen p...
Article
Tumors of the axilla are rare and pose a surgical challenge because they are usually large at presentation and in close proximity to the major neurovascular bundle of the upper extremity. The use of detailed preoperative evaluation studies and extensile surgical exposure for these tumors enabled us to determine tumor resectability and proceed with...
Article
10073 Background: Synovial sarcoma (SS) of an extremity or trunk is a relatively rare type of soft tissue sarcoma. SS most commonly affects adolescents and young adults. SS usually originates at an extremity, carries a t(X;18)(p11;q11) translocation, and approached by limb sparing surgery, radiation therapy, and chemotherapy. Methods: A retrospecti...
Article
Curettage and cryosurgery have been used successfully for treatment of benign locally aggressive and some low-grade malignant bone tumors. After treating these lesions, we reconstruct residual bone defects around the knee with cement, intramedullary pins, and autogenous bone graft for subchondral augmentation and closure of cortical windows. We que...
Article
Humeral suspension was the most popular reconstructive procedure after total scapulectomy until the early 1990s. Since 1992 the senior author has been performing scapular endoprosthetic reconstruction after total scapulectomy whenever the rhomboids, latissimus dorsi, deltoid, and trapezius were preserved. We hypothesized that scapular endoprostheti...
Article
Diffuse pigmented villonodular synovitis (PVNS) of the knee is a rare, locally aggressive disease. Since 1995 the senior author has been treating patients with diffuse intra- and extra-articular PVNS of the knee with a bimodality treatment protocol, consisting of anterior and posterior open synovectomies in conjunction with external-beam radiation....
Article
This study was undertaken to review our approach to diagnosis and treatment in a series of 11 patients (mean age 8.2 years) with primary pyomyositis, who had neither an underlying disease nor a compromised immune system. Nine of the children had positive blood cultures, Staphylococcus aureus (eight) and Streptococcus group A (one). The sites of inf...
Article
Soft tissue sarcomas of the popliteal fossa are rare diseases. Resection is challenging because of their extracompartmental location and proximity to neurovascular structures. Their prognosis is inferior to intracompartmental extremity soft tissue sarcomas. We ascertained the mode of initial presentation, the rates of local recurrence and distant m...
Article
Managing tumors of the proximal fibula may require en bloc resection of the fibular head with the attachment site for the lateral collateral ligament. These resections of the proximal fibula cause unavoidable knee instability. We describe a reconstructive technique intended to minimize that instability. We retrospectively reviewed 24 patients who h...
Article
Polytetrafluoroethylene vascular graft provides a mimetic anatomic reconstruction that restores the weight-bearing capacity of the leg and plantar-dorsiflexion of the hindfoot and ankle.
Article
Between December 1995 and March 2003, 38 adult patients with intermediate or high-grade liposarcoma in a limb were treated by limb-sparing surgery and post-operative radiotherapy. The ten-year local recurrence-free survival was 83%, the ten-year metastasis-free survival 61%, the ten-year disease-free survival 51% and the ten-year overall survival 6...
Article
Hemangioma of bone is a benign lesion with variable appearance on bone scintigraphy, from photopenia to a moderate increased tracer uptake. The common sites of involvement of hemangioma of bone are the vertebrae and the calvarium, locations accounting for at least 70% of cases. Some hemangiomas occur in the long bones, of which the tibia is the mos...
Article
The vascularized fibula flap has become a major tool in upper limb reconstruction. Free fibula flap reconstructions of the humeral part of the shoulder and the radial part of the wrist joints are well-documented, but reports of elbow joint reconstruction are rare. The authors report a 53-year-old patient with chronic osteomyelitis of the distal hum...
Article
Limb soft tissue sarcomas (STS) are currently treated with limb sparing surgery (LSS) followed by radiation therapy (RT). Between October 1994 and October 2002, 133 adult patients with intermediate or high-grade limb STS were approached by LSS+RT. RT related toxicity was manageable, with a low rate of severe effects. At 4-year median follow-up, the...
Article
Unlabelled: Resection of musculoskeletal tumors may result in large soft tissue defects that cannot be closed primarily and require prolonged dressing changes and complex surgical interventions for wound coverage. We retrospectively reviewed 23 patients with such defects treated with a vacuum-assisted wound closure system and compared the outcome...
Article
Malignant fibrous histiocytoma (MFH) is the most common subtype of soft-tissue sarcoma (STS). When located in a limb, MFH, is currently treated with limb sparing surgery (LSS) followed by radiation therapy (RT). During 8 years, 42 adult patients with high-grade limb MFH were approached by LSS and RT. Our results reflect a single-team experience and...
Article
To characterize the articular manifestations of cat-scratch disease (CSD) and to evaluate the long-term clinical outcome of those manifestations. A community- and hospital-based surveillance study of CSD was conducted in Israel between 1991 and 2002. CSD was defined as present in a patient when a compatible clinical syndrome and a positive confirma...
Article
Unlabelled: Metastatic bone disease of the humerus may require surgery for treatment of an impending or existing pathologic fracture or for alleviating disabling pain. Prompt restoration of function is a main goal of surgery, although published results do not reveal if that goal is being met. We retrospectively reviewed range of motion and functio...
Article
We report our experience with a new technique for cryosurgical ablation of bone tumours which allows accurate determination of the temperature and freezing time within a cavity of any geometrical shape. Between 1997 and 2000, 58 patients diagnosed with 13 malignant and 45 aggressive benign bone tumours underwent argon-based cryoablation. This techn...
Article
The fibula free flap became popular in orthopedic oncology for limb-sparing long bone tumor resection. It is particularly suitable for intercalary or resection arthrodesis options. In the present series, a surgical reconstruction algorithm was used, enabling each patient to receive a personalized technique. During the years 1998 to 2002, 30 patient...
Article
Full-text available
Spinal metastases of soft-tissue sarcoma (STS) occur rarely and pose a therapeutic problem. Although wide resection is warranted for best local control, it is rarely feasible. A radiotherapy (RT) dose of 70 Gy is usually needed to treat limb STS, but only 45 Gy can be given to the spine. In the present series, we report our experience using RT to t...
Article
Competence of the extensor mechanism is the major determinant of functional outcome of patients after proximal tibia resection. A method of secondary reconstruction of the extensor mechanism using the middle third of the quadriceps tendon and the patellar retinaculum augmented with Gore-Tex strips and gastrocnemius flap is described. Between 1981 a...
Chapter
Proximal and total femur resections are limb-sparing options for most primary bone sarcomas, metastatic lesions, and a variety of nononcologic indications of the proximal and midfemur that were traditionally treated with a major amputation. However, proximal and total femur resections are highly complex surgical procedures. Meticulous surgical tech...
Chapter
Soft-tissue tumors of the popliteal fossa and the posterior compartments of the leg are relatively uncommon. Patients with such tumors formerly were treated with amputations; however, better understanding of tumor biology and advances in chemotherapy and radiation therapy now allow the performance of limb-sparing procedures in the majority of these...
Chapter
Above-elbow amputations are indicated for advanced soft-tissue and bone sarcomas of the forearm; below-elbow amputations are performed for such tumors of the forearm and the hand. The location of the tumor mass on the medial aspect of the distal arm and elbow joint, in close proximity to the main neurovascular bundle, may in large part determine fe...
Chapter
The application of liquid nitrogen as a local adjuvant to curettage in the treatment of bone tumors was first introduced three decades ago. This technique, termed cryosurgery, was shown to achieve excellent local control in a variety of benign-aggressive and malignant bone tumors. However, early reports showed that cryosurgery has been associated w...
Chapter
Primary bone sarcomas of the fibula have traditionally been treated with above-knee amputations. Increased use of limb-sparing procedures stimulated an interest in the surgical anatomy of this area and the possibility that tumors of the fibula might be safely resected. This chapter describes the surgical anatomy and resection technique for malignan...
Chapter
Above-knee amputation is most often performed for advanced soft-tissue sarcomas of the distal thigh and leg, or for primary bone sarcomas of the distal femur and proximal tibia. It is usually indicated because of major involvement of the main neurovascular bundle or the presence of an extensive involvement of the soft tissues. Above-knee amputation...
Chapter
Below-knee amputation is usually performed for extensive high-grade soft-tissue sarcomas of the lower leg, ankle or foot. Primary bone sarcomas rarely occur in these locations. Extensive infiltration of tendons and ligaments and around bones in this area may preclude a functional extremity following wide excision. The almost universally good functi...
Chapter
Internal hemipelvectomies involve resection of part or all of the innominate bone with preservation of the extremity. This chapter will describe the surgical technique of resection of the ilium (Type I pelvic resection) and the pubic region (Type III pelvic resection).These resections do not violate the hip joint and minimally compromise the stabil...
Chapter
The bony pelvis and its enveloping soft tissues are a common site for bone and soft-tissue tumors. Extensive pelvic surgeries, either for oncologic reasons or following trauma, are highly demanding because of the irregular and complex shape of the bony pelvis, numerous muscle attachments, and the proximity of major blood vessels, nerves, and viscer...
Article
Tumor response to preoperative chemotherapy is an important prognostic factor for localized, operable extremity osteosarcoma. Other clinical variables include tumor size and location, age and sex, and serum enzymes. Advances in molecular oncology yielded a second group of factors such as multidrug resistance status, loss of heterozygosity of RB gen...