Argon Beam Coagulator (ABC)
Argon beam coagulation is a treatment given after the main treatment (adjuvant) treatment of benign aggressive bone tumors. Adjuvant therapy targets cancer cells that the primary cancer treatment didn’t destroy and reduces the chance you’ll have the same cancer again. ABC is used for extensive soft tissue resection and amputation. It is also used to treat the cavity after removal of bone tumors with the objective of lessening the chance that cancer will return. ABC might also be used for arthroscopic procedures (a surgical procedure used to visualize and treat problems inside a joint) where cauterization (the process of destroying tissue with electricity or chemicals to take away harmful tissue) is needed.
Bone Cement (Polymethylmethacrylate or PMMA)
Bone cement, which is also called polymethylmethacrylate or PMMA, is made of a powder and a liquid. When they’re mixed together, they form a hard substance like cement. This substance can fill the space where your diseased bone was removed. Bone cement is radiopaque, which means your surgeon can see it on your x-rays. They may also keep your bone in place with metal hardware, such as an orthopedic screw or pin. This hardware will be inside your bone and only visible on an x-ray. Metal hardware is only used if your surgeon thinks your bone will need extra support while it heals. The hardware may be left in for a long period of time or removed when your bone is fully healed.
Bone Grafting
A bone graft can be taken from you — this is called an autograft — or from a donor — which is known as an allograft. If you’re having an autograft, your surgeon will take the bone graft from your iliac bone (a bone in the upper part of your hip). After your surgery, you’ll have another incision near the top part of your hip. If you’re having an allograft, your surgeon will use sterilized bone chips. They may also use coral, which has many of the same properties as bone. Your surgeon will talk with you about which kind of bone graft will work best for you.
Cryotherapy (Cryosurgery or Cryoablation)
Cryotherapy, which is also called cryosurgery or cryoablation, is the freezing and killing of cancer cells. It’s sometimes used in addition to the curettage procedure. After removing the bone tumor, your surgeon will use liquid nitrogen to freeze the tumor cavity to subzero temperatures. This kills microscopic tumor cells and decreases the chance that the tumor will come back.
The frozen bone is stabilized by filling the tumor cavity with bone graft, cement or rods and screws to prevent fractures. Your surgeon will be extremely careful to protect your healthy bone when they remove the diseased bone.
Curettage
Curettage is a procedure used to treat enchondromas (non-cancerous bone tumors found in cartilage), bone cysts, low-grade lesions (areas of abnormal tissue) and metastatic disease (when cancer has spread beyond where it started) to the bone. Your surgeon will use a curette, a surgical tool that looks like a small ice cream scoop. This instrument has sharp edges that lets it scrape out the diseased part of your bone. After as much of the tumor is removed as possible, your surgeon might treat the nearby bone tissue with other techniques such as chemicals or extreme cold (cryosurgery) to try to kill any remaining tumor cells.