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Background: Infection rates post-surgery differ markedly between routine orthopaedic procedures and bone tumor surgeries, the latter significantly raising morbidity rates. Numerous strategies are being employed to decrease the infection rate in bone tumor surgeries. This study evaluates the effectiveness of antibiotic-loaded bone cement (ALBC) in reducing infection rates after curettage and cementation. Material and methods: This was a retrospective cohort study, including patients who were diagnosed with bone tumors and underwent curettage and cementation with or without fixation. Patient characteristics and perioperative specifics were collected from medical records, laboratory reports, operation reports, and outpatient follow-up databases. Surgical site infection (SSI) was defined following the criteria outlined by the Centers for Disease Control. Robust Poisson regression models, a frequently used multivariate technique under Generalized Linear Models with the Iterated Reweighted Least Squares algorithm, were used to measure the causal relationship. Results: In the cohort of 144 patients, six individuals (4.1%) developed SSI. Among them, 4 cases were superficial SSIs treated with antibiotics, and 2 cases were deep SSIs requiring surgical intervention. There was a significant difference in the incidence of SSI observed when comparing plain bone cement with ALBC, the latter showed a reduced risk, with a risk ratio of 0.06 (95% confidence interval: 0.006–0.61). Four factors were associated with SSI, including giant cell tumor of bone (GCTB), smoking, distal tumor location, and low serum albumin level. The type of antibiotic (Cefazolin vs. Clindamycin plus ceftazidime vs. Ceftriaxone) or the duration of intravenous antibiotic prescription did not impact the prevention of SSI. Conclusions: Our study reveals that ALBC may reduce the risk of SSI in curettage and cementation procedures. Additionally, the study identified independent risk factors for SSI, including GCTB, smoking, distal tumor location, and low serum albumin levels. Level of evidence: III.

Background. Leiomyosarcoma (LMS) is a soft tissue sarcoma that originates from smooth muscle cells and constitutes approximately 5–10% of all soft tissue sarcomas. Vascular LMS is the least common subtype of LMS. About one-third of vascular LMS is located in the extremities, most commonly in the saphenous vein (25%). Vascular LMS originating from the popliteal vein is very rare, and to the best of our knowledge, only nine cases have been reported to date. Case presentation. We herein report a case of a 49-year-old woman who presented with recurrence of a mass that was located at the posterior aspect of the right proximal leg and extended to the popliteal fossa. She had mild pain and intermittent claudication without a history of an edematous leg. The tissue diagnosis was LMS. Wide en bloc resection of the tumor, including the segment of the involved popliteal vein, was performed without venous reconstruction. The patient received no other adjuvant treatments. At the 16-month follow-up, she had good oncologic and functional outcomes. Conclusion. Vascular LMS at the popliteal vein is uncommon but should be considered as a differential diagnosis in a patient who presents with a mass at the popliteal fossa. The magnetic resonance imaging (MRI) and core needle biopsy were needed for a definite diagnosis. The mainstay of treatment is wide en bloc resection of the tumor, including the involved segment of the vein. Venous reconstruction after resection is unnecessary in chronic cases without a history of an edematous leg. Radiotherapy is an important adjuvant for local control when the surgical margins are close or positive. The role of chemotherapy in systemic management remains unclear.