Reconstruction after Talar Tumor Resection: A Systematic Review

Round 1

Reviewer 1 Report

The authors conducted a systematic review of talar reconstruction after tumor resection.

The methods are appropriate, and the discussion is well-written.

Because the talar tumor is extremely rare, only a few reports are available. Therefore, I think this review contributes to surgeons who deal with this rare disease.

Author Response

Responses to the Reviewer

Thank you for your detailed and thoughtful comments regarding our manuscript. We believe that our paper has markedly improved as a result of your valuable comments and feedback.

Comment

The authors conducted a systematic review of talar reconstruction after tumor resection.

The methods are appropriate, and the discussion is well-written.

Because the talar tumor is extremely rare, only a few reports are available. Therefore, I think this review contributes to surgeons who deal with this rare disease.

Response

Thank you for your detailed and thoughtful comments regarding our manuscript.

Reviewer 2 Report

Interesting article.

So far, there has been no a systematic review of thaler tumor resection.

I have a few comments:

Abstract:

Please add information that conclusions are drawn with caution as they concern a small number of patients (n=23).

Introduction:

Lines 32-37: Please do a larger review of the literature regarding incidence and epidemiology and histology of talar tumor.

TABLE 2: PLEASE DEFINE "Sensory deficit". Please describe whether the follow-up period is years or months.

Line 145: please describe: " sensory deficit ".

Author Response

Responses to the Reviewer

Thank you for your detailed and thoughtful comments regarding our manuscript. We believe that our paper has markedly improved as a result of your valuable comments and feedback.

Comment

Interesting article.

So far, there has been no a systematic review of thaler tumor resection.

I have a few comments:

Abstract:

Please add information that conclusions are drawn with caution as they concern a small number of patients (n=23).

Response

We added the following sentences in the Abstract as you suggested: “However, because this systematic review included only retrospective studies with a small number of patients, its results require re-evaluation in future randomized controlled trials with larger numbers of patients.”.

Comment

Introduction:

Lines 32-37: Please do a larger review of the literature regarding incidence and epidemiology and histology of talar tumor.

Response

We replaced the previous sentences with the following sentences in the “Introduction” section: “Approximately 8–15% of foot tumors occur in the talus [2-4]. Young et al. reported that, among 23 talar tumors, 17 (74%) were benign, three (13%) were intermediate, and three (13%) were malignant [5]. The breakdown is osteoid osteoma (7 cases), intraosseous ganglion (2 cases), osteochondroma (2 cases), membranous lipodystrophy (1 case), chondroblastoma (4 cases), desmoplastic fibroma (1 case), osteoblastoma (2 cases), giant cell tumor of bone (1 case), chondrosarcoma (2 cases), and osteosarcoma (1 case)[5]. The patients with benign talar tumors presented at a mean age of 25 years (range, 10–47 years) and those with malignant talar tumors at 49 years (range, 39–64 years) [5]. Murari et al. reported 17 primary talar tumors, including osteoblastoma (10 cases), chon-dromyxoid fibroma (2 cases), chondroblastoma (2 cases), giant cell tumor of bone (1 case), bone cyst (1 case), and osteochondroma (1 case), and osteoid osteoma (1 case)[3]. Dhillon et al. reported 12 primary talar tumors, including giant cell tumor of bone (5 cases), osteochondroma (2 cases), osteoblastoma (2 cases), Ewing's sarcoma (2 cases), and osteoid osteoma (1 case)[6].”.

Comment

TABLE 2: PLEASE DEFINE "Sensory deficit". Please describe whether the follow-up period is years or months.

Response

We added the following sentence in the footnote of Table 2: “*A partial sensory deficit in the distribution of the medial dorsal cutaneous nerve.”. We changed “y” into “year” in Table 2.

Comment

Line 145: please describe: " sensory deficit ".

Response

We replaced the previous sentence with the following sentence in the “Discussion” section: “Regarding complications, in the group of patients who underwent tibiocalcaneal fusion, a partial sensory deficit in the distribution of the medial dorsal cutaneous nerve.”.

Reviewer 3 Report

The article is really interesting and well written, but it needs a minor revision: to include the following sentence at the end of the "abstract":

However, because this systematic review included only retrospective studies with a small number of patients, its results require re-evaluation in future RCTs with larger numbers of patients.

Author Response

Responses to the Reviewer

Thank you for your detailed and thoughtful comments regarding our manuscript. We believe that our paper has markedly improved as a result of your valuable comments and feedback.

Comment

The article is really interesting and well written, but it needs a minor revision: to include the following sentence at the end of the "abstract":

However, because this systematic review included only retrospective studies with a small number of patients, its results require re-evaluation in future RCTs with larger numbers of patients.

Response

We added the following sentences in the Abstract as you suggested: “However, because this systematic review included only retrospective studies with a small number of patients, its results require re-evaluation in future randomized controlled trials with larger numbers of patients.”.

Round 2

Reviewer 2 Report

Manuscript for publication. 

Reviewer 3 Report

The authors have made the suggested changes in a right way. Therefore, I would accept the article in its present form (REVISION-1)