Scholars@Duke
Julia Dawn Visgauss

Julia Dawn Visgauss

Assistant Professor of Orthopaedic Surgery
Orthopaedic Surgery

Selected Publications

Novel niclosamide stearate prodrug therapeutic shows potential efficacy against naturally occurring canine osteosarcoma in a clinical feasibility study.

Journal Article Am J Vet Res · January 1, 2026 OBJECTIVE: To manufacture and characterize a modified niclosamide stearate (NS) prodrug therapeutic (mNSPT) for use in a small clinical trial in a metastatic canine osteosarcoma (OS) model. ANIMALS: 10 dogs that presented for treatment of nondetectable met ... Full text Link to item Cite

The impact of preoperative bone mineral density on outcomes following lower extremity megaprosthetic reconstruction for oncologic resections.

Journal Article Bone · January 2026 BACKGROUND: While megaprosthetic reconstructions have been instrumental in restoring patients' functional abilities, surgeons remain cautious of revision risk. This is the first study to assess the impacts of preoperative bone mineral density (BMD) on outc ... Full text Link to item Cite

Financial Toxicity among Survivors of Extremity and Pelvic Sarcoma: A Retrospective Study.

Journal Article Ann Surg Oncol · November 13, 2025 BACKGROUND: Financial toxicity in oncology, defined as the economic burden and psychosocial distress of cancer care, has been associated with poor clinical outcomes. Despite high projected treatment costs, data on financial toxicity in patients with sarcom ... Full text Link to item Cite

Chondroblastic Subtype Is Associated with Higher Rates of Local Recurrence in Skeletal Osteosarcoma.

Journal Article J Clin Med · November 10, 2025 Background/Objectives: Locally recurrent osteosarcoma is associated with high patient morbidity and mortality, yet the risk factors for local recurrence remain incompletely understood. Therefore, the objective of this study was to comprehensively assess th ... Full text Link to item Cite

Trends in Palliative Care Utilization in Patients with Bone Metastases.

Journal Article J Palliat Med · October 15, 2025 Background: Bone metastases cause significant symptom burden, yet patterns of palliative care (PC) utilization in this population remain poorly characterized. Objectives: To evaluate trends in PC use, compare inpatient palliative care (IPPC) and outpatient ... Full text Link to item Cite

Core needle biopsy of periacetabular chondrosarcoma often results in undergrading but does not change management by experienced orthopaedic oncologists.

Journal Article Sci Rep · September 30, 2025 There is discrepancy in the histologic concordance of pre-operative biopsy grading and post-surgical resection grading of periacetabular chondrosarcoma. This discrepancy poses a question as to whether the chosen treatment should depend upon on the initial ... Full text Link to item Cite

Sarcoma Patient Narratives With Respect to the Social Determinants of Health: A Thematic Analysis.

Journal Article Psychooncology · August 2025 OBJECTIVES: Sarcomas are rare, mesenchymal tumors that require multimodality treatment provided by multidisciplinary teams. This study seeks to better understand sarcoma patient narratives and quality of life in relation to the social determinants of healt ... Full text Link to item Cite

What Is the Cumulative Incidence of Femoral Stem Revision and Stem Complication in Cemented and Uncemented Hip Arthroplasty for Proximal Femoral Metastatic Bone Disease?

Journal Article Clin Orthop Relat Res · June 10, 2025 BACKGROUND: Hip arthroplasty is often indicated in metastatic bone lesions of the proximal femur, with or without pathologic fracture. Conventional knowledge is that cemented fixation is best, although uncemented fixation has potential advantages of shorte ... Full text Link to item Cite

Cryoablation of bone, soft tissue, and nerve in the setting of uninterrupted systemic cancer therapies.

Journal Article Clin Imaging · May 2025 PURPOSE: To assess safety of cryoablation in cancer patients receiving uninterrupted systemic cancer therapies with regard to wound healing. MATERIALS AND METHODS: In this single-institution IRB-approved retrospective study, all patients (29/50 (58 %) fema ... Full text Link to item Cite

IDH Mutations in Chondrosarcoma Correlate with Patient Survival in De-Differentiated but Not Conventional Subtypes.

Journal Article J Clin Med · April 29, 2025 Background: Chondrosarcoma is the second most common bone tumor in adults with an average incidence of 0.1-0.3 individuals per 100,000 per year. These tumors are often resistant to chemotherapy and radiation, and surgical excision is a mainstay of current ... Full text Link to item Cite

Identifying consensus and areas for future research in chondrosarcoma : a report from the Birmingham Orthopaedic Oncology Meeting.

Journal Article Bone Joint J · February 1, 2025 AIMS: The Birmingham Orthopaedic Oncology Meeting (BOOM), held in January 2024, convened 309 delegates from 53 countries to discuss and refine 21 consensus statements on the optimal management of chondrosarcoma. METHODS: With representation from Europe (43 ... Full text Link to item Cite

Locking plate augmentation of polymethylmethacrylate-filled distal femoral defects: A biomechanical study.

Journal Article J Orthop Res · January 2025 Benign, locally aggressive tumors of the distal femur are typically treated with intralesional curettage and polymethylmethacrylate (PMMA) cementation. However, it is not known whether plate fixation should be added to biomechanically augment these PMMA-fi ... Full text Link to item Cite

Exploring versatile applications of a vacuum-assisted bone harvester in orthopedic surgery.

Journal Article BMC Musculoskelet Disord · August 31, 2024 BACKGROUND: Orthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To mitigate thes ... Full text Link to item Cite

A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in three international cohorts.

Journal Article Lancet Digit Health · July 2024 BACKGROUND: Pulmonary complications are the most common cause of death after surgery. This study aimed to derive and externally validate a novel prognostic model that can be used before elective surgery to estimate the risk of postoperative pulmonary compl ... Full text Link to item Cite

ATRX and Its Prognostic Significance in Soft Tissue Sarcoma.

Journal Article Sarcoma · 2024 PURPOSE: Recently, the association between ATRX and a more aggressive sarcoma phenotype has been shown. We performed a retrospective study of sarcomas from an individual institution to evaluate ATRX as a prognosticator in soft tissue sarcoma. Experimental ... Full text Link to item Cite

Tripod Fixation of Periacetabular Metastatic Lesions Using the IlluminOss Device.

Journal Article JBJS Essent Surg Tech · 2024 BACKGROUND: Percutaneous tripod fixation of periacetabular lesions is performed at our institution for patients with metastatic bone disease and a need for quick return to systemic therapy. We have begun to use the IlluminOss Photodynamic Bone Stabilizatio ... Full text Link to item Cite

Regional anesthesia is associated with improved metastasis free survival after surgical resection of bone sarcomas.

Journal Article J Orthop Res · December 2023 There is increasing evidence that perioperative factors, including type of anesthesia, may be an important consideration regarding oncological disease progression. Previous studies have suggested that regional anesthesia can improve oncological outcomes by ... Full text Link to item Cite

Giant cell tumor of bone in the pediatric population: a retrospective study highlighting cases of metaphyseal only location and increased local recurrence rates in skeletally immature patients.

Journal Article Skeletal Radiol · December 2023 OBJECTIVE: To describe the presentation of giant cell tumors (GCT) of the bone in the pediatric population to (1) improve the differential diagnosis of pediatric bone tumors and (2) identify the origin of GCT. Understanding the origin of bone tumors assist ... Full text Link to item Cite

Tumor necrosis is an underappreciated histopathologic factor in the grading of chondrosarcoma.

Journal Article BMC Cancer · June 23, 2023 BACKGROUND: Cartilaginous neoplasms can be challenging to grade; there is a need to create an evidence-based rubric for grading. The goal of this study was to identify histopathologic features of chondrosarcoma that were associated with 5-year survival and ... Full text Link to item Cite

Juxtametallic Bipolar Bone Radiofrequency Ablation: Thermal Monitoring in an Ex-Vivo Model with Specimen MRI and Histopathologic Correlation.

Journal Article J Vasc Interv Radiol · December 2022 PURPOSE: To measure the ablation zone temperature and nontarget tissue temperature during radiofrequency (RF) ablation in bone containing metal instrumentation versus no metal instrumentation (control group). MATERIALS AND METHODS: Ex vivo experiments were ... Full text Link to item Cite

Antibiotic Prophylaxis for Megaprosthetic Reconstructions: Drug and Dosing May Matter More than Duration.

Journal Article Antimicrob Agents Chemother · October 18, 2022 In orthopedic oncology, the implant of a megaprosthetic device is standard of care after large-scale tumor resection involving segmental removal of bone. Infection remains the leading cause of implant failure, often resulting in major morbidity. Perioperat ... Full text Link to item Cite

Intraoperative angiography imaging correlates with wound complications following soft tissue sarcoma resection.

Journal Article J Orthop Res · October 2022 For soft tissue sarcoma patients receiving preoperative radiation therapy, wound complications are common and potentially devastating. The purpose of this study was to assess the feasibility of intraoperative indocyanine green fluorescent angiography (ICGA ... Full text Link to item Cite

Investigating readmission rates for patients undergoing oncologic resection and endoprosthetic reconstruction for primary sarcomas and tumors involving bone.

Journal Article J Surg Oncol · August 2022 BACKGROUND: Little is known about the drivers of readmission in patients undergoing Orthopaedic oncologic resection. The goal of this study was to identify factors independently associated with 90-day readmission for patients undergoing oncologic resection ... Full text Link to item Cite

Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma: A National Cancer Database Study.

Journal Article Ann Surg Oncol · February 2022 BACKGROUND: Limited data are available to inform the risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following su ... Full text Link to item Cite

Why Do Patients Undergoing Extremity Prosthetic Reconstruction for Metastatic Disease Get Readmitted?

Journal Article The Journal of arthroplasty · February 2022 BackgroundOrthopedic oncology patients are particularly susceptible to increased readmission rates and poor surgical outcomes, yet little is known about readmission rates. The goal of this study is to identify factors independently associated with ... Full text Cite

Extent of tumor fibrosis/hyalinization and infarction following neoadjuvant radiation therapy is associated with improved survival in patients with soft-tissue sarcoma.

Journal Article Cancer Med · January 2022 INTRODUCTION: Current standard of care for most intermediate and high-grade soft-tissue sarcomas (STS) includes limb-preserving surgical resection with either neoadjuvant radiation therapy (NRT) or adjuvant radiation therapy. To date, there have been a few ... Full text Link to item Cite

Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic.

Journal Article Br J Surg · December 1, 2021 BACKGROUND: This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS: This was a patient-level, comparative analysis ... Full text Link to item Cite

Staging and Surveillance of Myxoid Liposarcoma: Follow-up Assessment and the Metastatic Pattern of 169 Patients Suggests Inadequacy of Current Practice Standards.

Journal Article Ann Surg Oncol · November 2021 BACKGROUND: Unlike other sarcoma subtypes, myxoid liposarcoma (MLS) has a propensity for extra-pulmonary metastases. Computed tomography (CT) scan of the chest, abdomen, and pelvis has become an accepted practice for surveillance. However, recent literatur ... Full text Link to item Cite

Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Osteosarcoma: A National Cancer Database Study.

Journal Article Ann Surg Oncol · November 2021 BACKGROUND: There are limited data to inform risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following surgical r ... Full text Link to item Cite

Reverse total shoulder arthroplasty for oncologic reconstruction of the proximal humerus: a systematic review.

Journal Article J Shoulder Elbow Surg · November 2021 BACKGROUND: In recent years, there has been growing interest in the use of reverse total shoulder arthroplasty (rTSA) for reconstruction of the proximal humerus after oncologic resection. However, the indications and outcomes of oncologic rTSA remain uncle ... Full text Link to item Cite

Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study.

Journal Article Lancet Oncol · November 2021 BACKGROUND: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during ... Full text Link to item Cite

Treatment of Chondroblastoma with Denosumab: A Case Report with a Correlative Analysis of Effect on the RANK Signaling Pathway.

Journal Article JBJS Case Connect · May 17, 2021 CASE: A 15-year-old boy with chondroblastoma of the right hemipelvis presented with significant periacetabular bone destruction. Neoadjuvant denosumab treatment facilitated initial joint preserving surgery. Unfortunately, he experienced 2 local recurrences ... Full text Link to item Cite

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

Journal Article Br J Surg · January 27, 2021 BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer sur ... Full text Open Access Link to item Cite

The role of Denosumab in joint preservation for patients with giant cell tumour of bone.

Journal Article Bone Joint J · January 2021 AIMS: Local recurrence remains a challenging and common problem following curettage and joint-sparing surgery for giant cell tumour of bone (GCTB). We previously reported a 15% local recurrence rate at a median follow-up of 30 months in 20 patients with hi ... Full text Link to item Cite

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

Journal Article J Clin Oncol · January 1, 2021 PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with ... Full text Link to item Cite

The Utility of Chest Imaging for Surveillance of Atypical Lipomatous Tumors.

Journal Article Sarcoma · 2021 BACKGROUND: Unlike other soft tissue sarcomas, atypical lipomatous tumors (ALTs) are thought to have a low propensity for metastasis. Despite this, a standard of care for pulmonary metastasis (PM) surveillance has not been established. This study aimed to ... Full text Link to item Cite

Sarcoma treatment in the era of molecular medicine.

Journal Article EMBO Mol Med · November 6, 2020 Sarcomas are heterogeneous and clinically challenging soft tissue and bone cancers. Although constituting only 1% of all human malignancies, sarcomas represent the second most common type of solid tumors in children and adolescents and comprise an importan ... Full text Link to item Cite

Limb salvage versus amputation in patients with osteosarcoma of the extremities: an update in the modern era using the National Cancer Database.

Journal Article BMC Cancer · October 14, 2020 BACKGROUND: Historically, amputation was the primary surgical treatment for osteosarcoma of the extremities; however, with advancements in surgical techniques and chemotherapies limb salvage has replaced amputation as the dominant treatment paradigm. This ... Full text Link to item Cite

Designing a Rational Follow-Up Schedule for Patients with Extremity Soft Tissue Sarcoma.

Journal Article Ann Surg Oncol · June 2020 PURPOSE: The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tis ... Full text Link to item Cite

Midterm Success of a Custom, Non-Fluted, Diaphyseal, Press-Fit Stem Used With a Tumor Megaprosthesis System.

Journal Article J Arthroplasty · May 2020 BACKGROUND: High rates of aseptic loosening with cemented prostheses have led to increased utilization of uncemented stems in the setting of megaprosthetic reconstruction. Theoretic concerns of rotational instability resulted in early stem designs with de- ... Full text Link to item Cite

Race is an independent predictor of survival in patients with soft tissue sarcoma of the extremities.

Journal Article BMC Cancer · April 27, 2018 BACKGROUND: In the United States, race and socioeconomic status are well known predictors of adverse outcomes in several different cancers. Existing evidence suggests that race and socioeconomic status may impact survival in soft tissue sarcoma (STS). We i ... Full text Link to item Cite

The Value of MRI in Distinguishing Subtypes of Lipomatous Extremity Tumors Needs Reassessment in the Era of MDM2 and CDK4 Testing.

Journal Article Sarcoma · 2018 INTRODUCTION: Extremity lipomas and well-differentiated liposarcomas (WDLs) are difficult to distinguish on MR imaging. We sought to evaluate the accuracy of MRI interpretation using MDM2 amplification, via fluorescence in-situ hybridization (FISH), as the ... Full text Link to item Cite

Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends.

Journal Article J Shoulder Elbow Surg · December 2016 BACKGROUND: Patients with human immunodeficiency virus (HIV) infection were previously at substantial risk for immunosuppression-related complications. As a result of highly active antiretroviral therapy, HIV-infected patients are living longer and are pre ... Full text Link to item Cite

Sternoclavicular injuries

Chapter · June 17, 2016 Full text Cite

Innovations in Intraoperative Tumor Visualization.

Journal Article Orthop Clin North Am · January 2016 In the surgical management of solid tumors, adequacy of tumor resection has implications for local recurrence and survival. The standard method of intraoperative identification of tumor margin is frozen section pathologic analysis, which is time-consuming ... Full text Link to item Cite

Medial Patellofemoral Ligament Reconstruction Using a Femoral Loop Button Fixation Technique.

Journal Article Arthrosc Tech · October 2015 Medial patellofemoral ligament (MPFL) reconstruction is a common procedure used to treat both acute and chronic patellar instability. Although many variations of MPFL reconstruction have been described, there is no consensus regarding the optimal surgical ... Full text Link to item Cite