Our work

The mission of the UCSF Orthopaedic Oncology Clinical Research Section is to care for patients with bone and soft tissue tumors in a compassionate, personalized manner; to educate the public, our peers, and our students about musculoskeletal neoplasms; and to discover innovative solutions in basic, clinical, and translational research arenas.  Rosanna L. Wustrack, M.D. , Chief of Orthopaedic Oncology, is joined by Richard J. O’Donnell, M.D., Melissa N. Zimel, M.D., and recently-appointed Volunteer Associate Adjunct Professor Jonathan A. Forsberg, M.D., Ph.D. from Walter Reed and Johns Hopkins, to provide decades of surgical experience. 

The foundation of our research efforts lies in the UCSF Sarcoma Group, which brings together subspecialist musculoskeletal colleagues from Surgical Oncology, Pathology, Radiology, Radiation Oncology, and Medical Oncology.  Bench studies are supported by the UCSF Sarcoma Tumor Bank and focus on the host immune response to sarcomas and the potential of immunotherapy for treating these rare conditions.  Translational projects include the use of bone-anchored implants for limb salvage and amputation patients in the UCSF international Center for Osseointegration Research, Education, and Surgery (iCORES), as well as a variety of collaborative endeavors as part of the UCSF Musculoskeletal Research Consortium (METRiCS) that encompasses scientists from the Departments of Orthopaedic Surgery, Physical Therapy, Radiology, Medicine, Surgery, Neurosurgery, and Otolaryngology/Head and Neck Surgery; in the Schools of Medicine, Dentistry, and Pharmacy; and at UCSF and UC Berkeley. Clinical research ranges from retrospective reviews to multi-center prospective randomized controlled trials for bone and soft tissue sarcoma management.  We welcome inquiries and participation from like-minded researchers from the undergraduate to post-doctoral levels.

Current projects

The UCSF Orthopaedic Oncology Section currently has a total of 24 research protocols approved by the UCSF Institutional Review Board (IRB), including four orthopaedic clinical trials for a variety of patient populations.  More than 30 sarcoma clinical trials at UCSF can be found at https://clinicaltrials.ucsf.edu/sarcoma. Interested individuals can contact our program at OrthoOncinfo@ucsf.edu. Our research is funded in part through five federal contracts and grants. We are thankful for the support of colleagues and funders at the Department of Defense Osseointegration Program; the Walter Reed National Military Medical Center; the Uniformed Services University; the Defense Advanced Research Projects Agency (DARPA); the U.S. Army Medical Research and Development Command (USAMRDC); the Congressionally Directed Medical Research Program (CDMRP); the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF); the James O. Johnston, M.D. Immunotherapy Fund; the Stern Family Fund; the Musculoskeletal Tumor Society; the  Massachusetts Institute of Technology; Harvard Medical School; the Brigham and Women’s Hospital; the Johns Hopkins University; and the University of California, Berkeley.

IRB approved research protocols  

   1.  18-25115 Neuroimaging-Based Objective Diagnostic Tool to Detect Subjective Tinnitus 
   2.  21-33990 OPRA Implant System Premarket Approval and Related Studies
   3.  20-32576 A 2-year follow-up, multidisciplinary study focused on outcomes and experience with the OPRA Axor II coupling unit
   4.  20-31453 Phantom limb pain multimodal imaging
   5.  20-30438 COVID-19: Surgical implications study
   6.  20-30167 Osseointegration Quality Registry 
   7.  19-28003 ASSIST: Amputee Smart Safe Implant Sensor Technology
   8.  19-28002 Focused ultrasound to promote immune response for undifferentiated pleomorphic sarcoma
   9.  18-25641 Transfemoral Amputation Osseointegration Study, TFAOS, Non-Research, HUD Only
  10.  18-25404 Transfemoral Amputation Osseointegration Study, TFAOS, Research
  11. 18-24966 Transhumeral e-OPRA, An osseoanchored percutaneous prosthesis study evaluating stable neural signal transmission in subjects with transhumeral amputations
  12. 18-24855 Incidence of amputees who may be candidates for an osseointegrated percutaneous prosthetic system
  13. 17-22205 Patient Preferences for Attributes of Risk and Benefit of Prosthetic Devices for Upper Limb Loss
  14. 17-21928 An osseointegrated transfemoral prosthesis offering long-term bi-directional efferent-afferent neural transmission (IDE)
  15. 16-20570 Phase III study to compare the effectiveness of magnetic resonance guided focused ultrasound for osteoid osteoma  
  16. 16-20528 The effect of intraoperative radiation on skin graft viability in soft tissue sarcoma resection
  17. 16-19786 Transhumeral Amputation Osseointegration Study, TAOS
  18. 16-18627 Retrospective study of neoadjuvant chemotherapy for pleomorphic undifferentiated sarcoma
  19. 15-18025 Compressive osseointegration for distal femur reconstruction in giant cell tumor
  20. 15-16764 Osseointegrated percutaneous prosthetic system for transfemoral amputees; A prospective cohort study
  21. 15-16385 Biospecimen acquisition protocol for analysis of biomarkers in cancers
  22. 15-16384 Molecular profiling in bone and soft tissue malignancies
  23. 15-15810 PARITY: Prophylactic Antibiotic Regimens In Tumor surgery
  24. 11-07304 Identifying molecular alterations in secondary malignant neoplasms
  25. 11-06107 Collection of blood, sputum, exhaled breath condensate and tissue samples from patients with suspected or biopsy-proven malignancies
  26. 11-05361 Tumor marker expression in bone and soft tissue tumors
  27. 10-02939 Reconstruction of massive defects using the ComPreSs device for endoprosthetic fixation in the proximal femur, distal femur, proximal tibia and humerus
  28. 10-01111 Molecular markers in sarcoma and pulmonary metastasis

Clinical trials

    1. DARPA-W911NF-17-2-0043. An osseointegrated transfemoral prosthesis offering long-term bi-directional efferent-afferent neural transmission.

    2. W81XWH-17-2-0060, USAMRMC-BA160465. Transfemoral Amputee Osseointegration Study (TFAOS).

    3. DARPA-15-05-OpenBAA-FP-014. An osseo-neural transtibial prosthesis with efferent-afferent control.

    4.  W81XWH-19-OPORP-CRA. Assessing biomechanical function and hip stabilizing muscle quality associated with transfemoral osseointegration.

Publications

1. COVIDSurg Collaborative. Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery uring the SARS-CoV-2 pandemic. Brit. J. Surg., 00():1-9, 2020.
2. Glasbey, J.C.; Neopgodiev, D.; Simoes, J.F.F.; et al. Elective cancer surgery in COVID-19–free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study. J. Clin. Onc., 39(1):66-78, 2020. PMID: 33021869. 
3.  Outcomes of Elderly Patients with Soft Tissue Sarcoma of the Extremities. International Journal of Radiation Oncology • Biology • Physics. 2020 Nov 1; 108(3):e6. J. Chew, S.A. Lloyd, R.A. Okimoto, A. Sabnis, E. Nakakura, C. Corvera, M.N. Zimel, A.E. Horvai, S.J. Cho, R.L. Wustrack, A.R. Gottschalk, R.J. O'Donnell, T.M. Jahan, S.E. Braunstein.
4.   Musculoskeletal Effects of Cancer and Cancer Treatment. J Am Acad Orthop Surg. 2020 Aug 15; 28(16):e716-e728. Wustrack R, Rao SS, Morris CD. PMID: 32769720.
5. Butte, Z.; Tanaka, K.; Andaya, V.; Zimel, M.; O'Donnell, R.J.; and Wustrack, R. Risk of endo prosthetic infection and impact of health-related quality of life in patients with osteosarcoma and giant cell tumor of bone; a retrospective case-control study. Ann. Joint, 2020. doi:10.21037/aoj.2020.0203.
6. Penumarthy N.L.; Goldsby, R.E.; Shiboski, S.C.; Wustrack.; Murphy, P.; and Winestone L.E. Insurance impacts survival for children, adolescents, and young adults with bone and soft tissue sarcomas. Cancer Med., 9(3):951-958, 2020. doi:10.1002/cam4.2739. Epub 2019 Dec 15. PubMed PMID:31838786.
7. Gutierrez, L.B.; Link, T.M.; Horvai, A.E.; Joseph, G.B.; O'Donnell, R.J.; and Motamedi, D. Secondary aneurysmal bone cysts and associated primary lesions: Imaging features of 49 cases. Clin. Imaging, 62:23-32, 2020. doi: 10.1016/j.clinimag.2020.01.022. Epub 2020 Jan 30. PubMed PMID: 32036238.
8. Zaid, M.B.; O'Donnell, R.J.; Potter, B.K.; and Forsberg, J.A. Orthopaedic osseointegration: State of the art. J. Amer. Acad. Orthop. Surg., 27(22):e977-e985, 2019. doi: 10.5435/JAAOS-D-19-00016. PubMed PMID: 31181031.
9. Strongy, J.;  Brown, S.; Choong, P.; Ghert, M.; Jeys, L.; and O’Donnell, R.J. Musculoskeletal infection in orthopaedic oncology: Assessment of the 2018 International Consensus Meeting on Musculoskeletal Infection. J. Bone Joint Surg., 101-A(20):e107, 2019. doi: 10.2106/JBJS.19.00182. PubMed PMID: 31626015.
10. Heunis, J.S.;  Cheah, J.W.; Sabnis, A.J.; and Wustrack, R.L. Use of three-dimensional printing and intraoperative navigation in the surgical resection of metastatic acetabular osteosarcoma. BMJ Case Rep., 12(9):e230238, 2019. doi: 10.1136/bcr-2019-230238. PubMed PMID: 31570349.
11. Zaid, M.B.; Wustrack, R.L.;  Garibaldi, M.; Geiger, E.; Andaya, V.; and O’Donnell, R.J. Prospective study of percutaneous bone-anchored implants in transfemoral amputees: Brain-machine platform technology for external prosthetic control and feedback. Conf. Proc. IEEE Eng. Med. Biol. Soc., 2019:13-16, 2019.
12. Baal, J.D.; Pai, J.S.; Chen, W.C.; Joseph, G.B.; O’Donnell, R.J.; and Link, T.M. Factors associated with osteoid osteoma recurrence following CT-guided radiofrequency ablation. J. Vasc. Intervent. Radiol., 30(5): 744-751, 2019. doi: 10.1016/j.jvir.2018.11.014. Epub 2019 Mar 14. PubMed PMID: 30879870.
13. Zaid, M.;  Chavez, M.R.; Carrasco, A.E.; Zimel, M.N.; Zhang, A.L.; Horvai, A.E.; Link, T.M.; and O’Donnell, R.J. Cutibacterium (formerly Propionibacterium) acnes clavicular infection. J. Bone Joint Infect., 4(1):40-49, 2019. doi: 10.7150/jbji.29153. PubMed PMID: 30755847.
14. Pandya,  N.K.; Wustrack, R.; Metz, L.; and Ward, D. Current concepts in orthopaedic care disparities. J. Am. Acad. Orthop. Surg., 26(23):823-832, 2018. doi: 10.5435/JAAOS-D-17-00410. PubMed PMID: 30180094.
15. Loy,  B.N.; Zimel, M.; Gowda, A.L.; Tooley, T.R.; Maerz, T.; Bicos, J.; and Guettler, J. A biomechanical and structural comparison of articular cartilage and subchondral bone of the glenoid and humeral head. Orthop. J. Sports Med., 20;6(7):2325967118785854, 2018. doi: 10.1177/2325967118785854. PubMed PMID: 30046634.
16. von Mehren, M.; Randall, R.L.; Benjamin, R.S.; Boles, S.; Bui, M.M.; Ganjoo, K.N.; George, S.; Gonzalez, R.J.; Heslin, M.J.; Kane, J.M.; Keedy, V.; Kim, E.; Koon, H.; Mayerson, J.; McCarter, M.; McGarry, S.V.; Meyer, C.; Morris, Z.S.; O'Donnell, R.J.; Pappo, A.S.; Paz, I.B.; Petersen, I.A.; Pfeifer, J.D.; Riedel, R.F.; Ruo, B.; Schuetze, S.; Tap, W.D.; Wayne, J.D.; Bergman, M.A.; and Scavone, J.L. Soft tissue sarcoma, version 2.2018. J. Natl. Compr. Canc. Netw., 16(5):536-563, 2018. doi: 10.6004/jnccn.2018.0025. PubMed PMID: 29752328.
17. Weiss, K.R.; and Zimel, M.N. Considerations for the long term treatment of pediatric sarcoma survivors. Indian J. Orthop., 52(1):77-80, 2018. doi: 10.4103/ortho.IJOrtho_248_17. PubMed PMID: 29416174.
18. Zimel, M.N.;  Horowitz, C.B.; Rajasekhar, V.K.; Christ, A.B.; Wei, X.; Wu, J.; Wojnarowicz, P.M.; Wang, D.; Goldring, S.R.; Purdue, P.E.; and Healey, J.H. HPMA-copolymer nanocarrier targets tumor-associated macrophages in primary and metastatic breast cancer. Mol. Cancer Ther., 16(12):2701-2710, 2017. doi: 10.1158/1535-7163.MCT-15-0995. Epub 2017 Aug 22. PubMed PMID: 28830983.
19. Shaw, J.D.; Miller, S.; Plourde, A.; Shaw, D.L.; Wustrack, R.; and Hansen, E.N. Methylene blue-guided debridement as an intraoperative adjunct for the acute surgical treatment of periprosthetic joint infection. J Arthroplasty, 32(12):3718-3723, 2017. doi: 10.1016/j.arth.2017.07.019. Epub 2017 Jul 21. PubMed PMID: 28811108.
20. Morris, C.D.; Wustrack, R.L.; and Levin, A.S. Limb-salvage options in growing children with malignant bone tumors of the lower extremity: A critical analysis review. JBJS Rev., 5(7):e7, 2017. doi: 10.2106/JBJS.RVW.16.00026. PubMed PMID: 28742715.
21. Serborne, A.L.; Lavergne, V.; Yu, K.; Lee, L.; Davidson, P.R.; Mazor, T.; Smirnoff, I.V.; Horvai, A.E.; Loh, M.; DuBois, S..G.; Goldsby, R.E.; Neglia, J.P.; Hammond, S.; Robison, L.L.; Wustrack, R.; Costello, J.F.; Nakamura, A.O.; Shannon, K.M.; Bhatia, S.; and Nakamura, J.L. Somatic and germline TP53 alterations in second malignant neoplasms from pediatric cancer survivors. Clin. Cancer Res., 23(7):1852-1861, 2017. doi: 10.1158/1078-0432.CCR-16-0610. Epub 2016 Sep 28. PubMed PMID: 27683180.
22. Biermann, J.S.; Chow, W.; Reed, D.R.: Lucas, D.; Adkins, D.R.; Agulnik, M.; Benjamin, R.S.; Brigman, B.; Budd, G.T.; Curry, W.T.; Didwania, A.; Fabbri, N.; Hornicek, F.J.; Kuechle, J.B.; Lindskog, D.; Mayerson, J.; McGarry, S.V.; Million, L.; Morris, C.D.; Movva, S.; O'Donnell, R.J.; Randall, R.L.; Rose, P.; Santana, V.M.; Satcher, R.L.; Schwartz, H.; Siegel, H.J.; Thornton, K.; Villalobos, V.; Bergman, M.A.; and Scavone, J.L. NCCN Guidelines Insights: Bone Cancer, Version 2.2017. J. Natl. Compr. Canc. Netw., 15(2):155-167, 2017. PubMed PMID: 28188186.
23. Lansdown, D.A.; Whitaker, A.; Wustrack, R.; Sawyer, A.; and Hansen, E.N. A resident-led initiative improves screening and treatment for vitamin D deficiency in patients with hip fractures. Clin. Orthop. Relat. Res., 475(1):264-270, 2017. doi: 10.1007/s11999-016-5036-4. Epub 2016 Aug 22. PubMed PMID: 27549989.
24. Wustrack, R.;  Cooper, K.; and Weber, K. Molecular markers in bone and soft-tissue tumors. JBJS Rev., 4(8):01874474-201608000-00005, 2016. doi: 10.2106/JBJS.RVW.15.00092. PubMed PMID: 27603273.
25. Goldman, L.H.; Morse L.J.; O’Donnell, R.J.; and Wustrack, R.L. How often does spindle failure occur in compressive osseointegration endoprostheses for oncologic reconstruction? Clin. Orthop. Rel. Res., 474(7):1714-1723, 2016. doi: 10.1007/s11999-016-4839-7. Epub 2016 Apr 22. PubMed PMID: 27106130.
26. Najajima, K.; Kho, D.H; Yanagawa, T.; Zimel, M.; Heath, E.; Hogan, V.; and Raz, A. Galectin-3 in bone tumor microenvironment: A beacon for individual skeletal metastasis management. Cancer Metastasis Rev. 35(2):333-46, 2016. doi: 10.1007/s10555-016-9622-4. PubMed PMID: 27067726.
27. Zimel, M.N.; Farfalli, G.L.; Zindman, A.M.; Riedel, E.R.; Morris, C.D.; Boland, P.J.; and Healey, J.H. Revision distal femoral arthroplasty with the Compress() prosthesis has a low rate of mechanical failure at 10 years. Clin. Orthop. Relat. Res., 474(2):528-36, 2016. doi: 10.1007/s11999-015-4552-y. Epub 2015 Sep 22. PubMed PMID: 26394638.