Bone and Soft Tissue Disorders: Pathological Diagnosis, Surgical Reconstruction, and Long-Term Medical Outcomes

Urooj Nasir; Riya Binoy Maniyar; Monia Mohosina Moni; Muhammad Saad Anwaar; Muhammad Hamza Alam; Qaiser Shaikh

doi:10.70749/ijbr.v3i10.2487

Authors

Urooj Nasir Prime institute of health sciences, Islamabad, Pakistan. https://orcid.org/0009-0000-1068-1987
Riya Binoy Maniyar Department of Medicine, Maharashtra University of Health Sciences, Nashik, India.
Monia Mohosina Moni Department of Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom.
Muhammad Saad Anwaar Department of Medicine, Pakistan Institute of Medical Sciences (PIMS) Hospital, Islamabad, Pakistan.
Muhammad Hamza Alam Abbasi Shaheed Hospital, Karachi, Pakistan.
Qaiser Shaikh Nixor College, Karachi, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i10.2487

Keywords:

Bone and soft tissue disorders, Diagnostic accuracy, Molecular profiling, Surgical reconstruction, Functional recovery, Quality of life.

Abstract

This quantitative cross-sectional study evaluated the diagnostic accuracy, surgical efficacy, and long-term outcomes of patients with bone and soft tissue disorders, integrating pathological, surgical, and clinical perspectives. The objectives were to (1) assess the accuracy and effectiveness of diagnostic techniques—including histopathology, immunohistochemistry, and molecular profiling—in identifying and classifying musculoskeletal pathologies; (2) analyze the impact of surgical reconstruction strategies on structural restoration, function, and quality of life; and (3) evaluate long-term medical outcomes and complications following surgical management. Data were collected from 210 patients treated at three tertiary hospitals between 2018 and 2024, using purposive sampling and structured record review. Diagnostic accuracy was analyzed using descriptive statistics, Pearson correlation, and ANOVA, while multiple regression examined predictive relationships among diagnostic precision, surgical technique, and recovery indicators through SPSS version 26. Results revealed that combined diagnostic approaches yielded the highest mean accuracy (94.58%) compared with histopathology (82.45%) and immunohistochemistry (87.33%). Advanced surgical methods such as vascularized bone transfer achieved superior functional (91.48%) and HRQoL scores (92.95%) with lower complication rates (9.7%). Long-term outcomes indicated high functional recovery (88.73%) and patient satisfaction (89.12%), though recurrence (11.42%) and chronic pain (14.27%) persisted as clinical concerns. The study concludes that integrated molecular diagnostics and innovative reconstructive strategies significantly improve diagnostic reliability, recovery rate, and quality of life among patients with bone and soft tissue disorders.

Downloads

Download data is not yet available.

References

1. Beird, H.C., et al., Osteosarcoma. Nature reviews Disease primers, 2022. 8(1): p. 77.

https://doi.org/10.1038/s41572-022-00411-4

2. Bedi, M., et al., Is 5 the new 25? Long-term oncologic outcomes from a phase II, prospective, 5-fraction preoperative radiation therapy trial in patients with localized soft tissue sarcoma. Advances in radiation oncology, 2022. 7(3): p. 100850.

https://doi.org/10.1016/j.adro.2021.100850

3. Roccuzzo, M., et al., The importance of soft tissue condition in bone regenerative procedures to ensure long‐term peri‐implant health. Periodontology 2000, 2023. 93(1): p. 129-138.

https://doi.org/10.1111/prd.12496

4. Galarraga‐Vinueza, M.E. and L. Tavelli, Soft tissue features of peri‐implant diseases and related treatment. Clinical implant dentistry and related research, 2023. 25(4): p. 661-681.

https://doi.org/10.1111/cid.13156

5. Rapone, B., et al., Long-term outcomes of implants placed in maxillary sinus floor augmentation with porous fluorohydroxyapatite (Algipore® FRIOS®) in comparison with Anorganic bovine bone (bio-Oss®) and platelet rich plasma (PRP): a retrospective study. Journal of Clinical Medicine, 2022. 11(9): p. 2491.

https://doi.org/10.3390/jcm11092491

6. Hayes, A.J., et al., UK guidelines for the management of soft tissue sarcomas. British journal of cancer, 2025. 132(1): p. 11-31.

https://doi.org/10.1038/s41416-024-02674-y

7. Angelini, A., et al., One-stage soft tissue reconstruction following sarcoma excision: a personalized multidisciplinary approach called “orthoplasty”. Journal of Personalized Medicine, 2020. 10(4): p. 278.

https://doi.org/10.3390/jpm10040278

8. Frobert, P., et al. The role of reconstructive surgery after soft tissue sarcoma resection. in Annales de Chirurgie Plastique Esthétique. 2020. Elsevier.

https://doi.org/10.1016/j.anplas.2020.05.009

9. Kask, G., et al., Soft tissue sarcoma of lower extremity: functional outcome and quality of life. Annals of Surgical Oncology, 2021. 28(11): p. 6892.

https://doi.org/10.1245/s10434-021-09774-6

10. Schutgens, E., et al., Surgical outcome and oncological survival of osteofibrous dysplasia-like and classic adamantinomas: an international multicenter study of 318 cases. JBJS, 2020. 102(19): p. 1703-1713.

https://doi.org/10.2106/jbjs.19.01056

11. Gallaway, K.E., J. Ahn, and A.K. Callan, Thirty‐day outcomes after surgery for primary sarcomas of the extremities: an analysis of the NSQIP database. Journal of Oncology, 2020. 2020(1): p. 7282846.

https://doi.org/10.1155/2020/7282846

12. Schwarzkopf, E., et al., Adamantinomatous tumors: long‐term follow‐up study of 20 patients treated at a single institution. Journal of surgical oncology, 2020. 122(2): p. 273-282.

https://doi.org/10.1002/jso.25950

13. Wald, O., et al., 11-year experience with Chest Wall resection and reconstruction for primary Chest Wall sarcomas. Journal of Cardiothoracic Surgery, 2020. 15(1): p. 29.

https://doi.org/10.1186/s13019-020-1064-y

14. Cebrián Carretero, J.L., et al., Virtual surgical planning and customized subperiosteal titanium maxillary implant (CSTMI) for three dimensional reconstruction and dental implants of maxillary defects after oncological resection: case series. Journal of Clinical Medicine, 2022. 11(15): p. 4594.

https://doi.org/10.3390/jcm11154594

15. Nakayama, R., et al., A multidisciplinary approach to soft-tissue sarcoma of the extremities. Expert Review of Anticancer Therapy, 2020. 20(10): p. 893-900.

16. Azoury, S.C., et al., Principles of orthoplastic surgery for lower extremity reconstruction: why is this important? Journal of Reconstructive Microsurgery, 2021. 37(01): p. 042-050.

https://doi.org/10.1055/s-0039-1695753

17. Barootchi, S. and H.-L. Wang, Peri-implant diseases: Current understanding and management. Int J Oral Implantol (Berl), 2021. 14(3): p. 263-82.

18. Allen Jr, R.J., et al., Short-Term Outcomes following Virtual Surgery–Assisted Immediate Dental Implant Placement in Free Fibula Flaps for Oncologic Mandibular Reconstruction. Plastic and reconstructive surgery, 2020. 146(6): p. 768e-776e.

https://doi.org/10.1097/prs.0000000000007352

19. Erol, B., et al., Reconstruction after periacetabular tumor resection with Lumic® endoprosthesis: What are the midterm results? Journal of Surgical Oncology, 2021. 123(2): p. 532-543.

https://doi.org/10.1002/jso.26318

20. Chira, S., et al., Progresses towards safe and efficient gene therapy vectors. Oncotarget, 2015. 6(31): p. 30675.

https://doi.org/10.18632/oncotarget.5169

21. Vallejo-Rosero, K.A., et al., Conservative management of odontogenic keratocyst with long-term 5-year follow-up: Case report and literature review. International Journal of Surgery Case Reports, 2020. 66: p. 8-15.

https://doi.org/10.1016/j.ijscr.2019.11.023

22. Al-Nawas, B., et al., ITI consensus report on zygomatic implants: indications, evaluation of surgical techniques and long-term treatment outcomes. International journal of implant dentistry, 2023. 9(1): p. 28.

https://doi.org/10.1186/s40729-023-00489-9

23. Zöllner, S.K., et al., Ewing sarcoma—diagnosis, treatment, clinical challenges and future perspectives. Journal of clinical medicine, 2021. 10(8): p. 1685.

https://doi.org/10.3390/jcm10081685

24. Wininger, A.E., et al., Musculoskeletal pathology as an early warning sign of systemic amyloidosis: a systematic review of amyloid deposition and orthopedic surgery. BMC Musculoskeletal Disorders, 2021. 22(1): p. 51.

https://doi.org/10.1186/s12891-020-03912-z

25. Muratori, F., et al., Long term outcome of surgical treatment of chondroblastoma: analysis of local control and growth plate/articular cartilage related complications. BMC Musculoskeletal Disorders, 2023. 24(1): p. 139.

https://doi.org/10.1186/s12891-023-06239-7

26. Llacer-Moscardo, C., et al., Pre-or postoperative radiotherapy for soft tissue sarcomas. Cancer/Radiothérapie, 2020. 24(6-7): p. 501-512.

https://doi.org/10.1016/j.canrad.2020.05.007

27. Jepsen, K., A. Sculean, and S. Jepsen, Complications and treatment errors involving periodontal tissues related to orthodontic therapy. Periodontology 2000, 2023. 92(1): p. 135-158.

https://doi.org/10.1111/prd.12484

28. Guadagnolo, B.A., et al., Hypofractionated, 3-week, preoperative radiotherapy for patients with soft tissue sarcomas (HYPORT-STS): a single-centre, open-label, single-arm, phase 2 trial. The Lancet Oncology, 2022. 23(12): p. 1547-1557.

https://doi.org/10.1016/s1470-2045(22)00638-6

29. Marcianò, A., et al., Oral surgical management of bone and soft tissues in MRONJ treatment: a decisional tree. Life, 2020. 10(7): p. 99.

https://doi.org/10.3390/life10070099

30. Gamboa, A.C., A. Gronchi, and K. Cardona, Soft‐tissue sarcoma in adults: an update on the current state of histiotype‐specific management in an era of personalized medicine. CA: a cancer journal for clinicians, 2020. 70(3): p. 200-229.

https://doi.org/10.3322/caac.21605

31. Isaac, A., et al., State-of-the-art imaging for diagnosis of metastatic bone disease. Der Radiologe, 2020. 60(Suppl 1): p. 1-16.

https://doi.org/10.1007/s00117-020-00666-6

32. Bertoldi, C., et al., Clinical and histological reaction of periodontal tissues to subgingival resin composite restorations. Clinical Oral Investigations, 2020. 24(2): p. 1001-1011.

https://doi.org/10.1007/s00784-019-02998-7

33. Gonfiotti, A., et al., Chest wall reconstruction with implantable cross-linked porcine dermal collagen matrix: Evaluation of clinical outcomes. JTCVS techniques, 2022. 13: p. 250-260.

https://doi.org/10.1016/j.xjtc.2022.01.021

34. Djuraev, A.M., K.S. Alpisbaev, and E.A. Tapilov, The choice of surgical tactics for the treatment of children with destructive pathological dislocation of the hip after hematogenous osteomyelitis. International Journal of Health & Medical Sciences, 2021. 5(1): p. 15-20.

https://doi.org/10.21744/ijhms.v5n1.1813

35. Kiiski, J., et al., Surgical and oncological outcomes after hindquarter amputation for pelvic sarcoma: who will benefit from the procedure? The bone & joint journal, 2020. 102(6): p. 788-794.

https://doi.org/10.1302/0301-620x.102b6.bjj-2019-1317.r1