Robert Weinschenk, M.D.

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Robert Weinschenk, M.D. Robert Weinschenk, M.D., is an Assistant Professor in the Department of Orthopaedic Surgery at UT Southwestern Medical Center.

Orthopedic oncology surgeon in Dallas, TX with clinical focus on bone and soft tissue sarcomas, metastatic disease, as well as benign bone and soft tissue tumors. He specializes in musculoskeletal oncology, focusing on benign and malignant tumors of the extremities and pelvis. His clinical interests also include osteoarthritis and traumatic skeletal injuries. Dr. Weinschenk earned his medical degree at Wake Forest School of Medicine. He completed a residency in orthopaedic surgery at Baylor Scott & White Medical Center – Temple and received advanced training in musculoskeletal oncology through a fellowship at MD Anderson Cancer Center. Following the traditional clinical year, Dr. Weinschenk remained at MD Anderson for an additional year dedicated to clinical and translational research. He joined the UT Southwestern faculty in 2021. He is designated as a Clinical Scholar at UT Southwestern, with substantial efforts dedicated to research in addition to his clinical practice. His primary research interests involve applications of 3D printing to biomechanical studies, patient education, and resident/student training.

This is a patient in his early 20s who had insidious onset of right hip pain. An abnormal lesion was discovered in his r...
04/02/2025

This is a patient in his early 20s who had insidious onset of right hip pain. An abnormal lesion was discovered in his right iliac wing. A biopsy confirmed the diagnosis of low-grade osteosarcoma.

Most osteosarcomas required both chemotherapy and surgery, but this being low-grade, only required surgery. After resecting enough bone and soft tissue to achieve a wide margin, specimens are taken to pathology, each surface is inked a different color for later analysis by the pathologist, and the specimen is cut so we can visualize the resected tumor and normal tissue surrounding it. Suture anchors were used to secure a bioprosthetic mesh to the defect in the pelvis and close the abdominal wall to prevent a hernia.

The patient is now ambulating well and has made an excellent recovery!

Pro 3D-printing tip: When your resin is about to expire, instead of trashing it, ask your team to print some dinosaurs f...
23/11/2024

Pro 3D-printing tip: When your resin is about to expire, instead of trashing it, ask your team to print some dinosaurs for your 2 year old!

This is a patient in her mid-60s who unfortunately was diagnosed with metastatic phyllodes tumor, a rare cancer originat...
08/11/2024

This is a patient in her mid-60s who unfortunately was diagnosed with metastatic phyllodes tumor, a rare cancer originating in the breast. After spreading to her humerus, she suffered from a pathologic fracture. Sometimes when cancer spreads to bone, we can’t rely on the biology of the bone for the fracture to heal like we can in typical orthopedic trauma. In these cases, sometimes after removing the cancer from the bone, we will fill the defect with bone cement to help reinforce it. When exposing these areas it’s always important to identify and protect critical neurovascular structures, in this case, the radial nerve!

This is an 18-year-old patient with a very large osteosarcoma of the left femur that has grown out of the bone and into ...
08/11/2024

This is an 18-year-old patient with a very large osteosarcoma of the left femur that has grown out of the bone and into much of the soft tissue in the thigh. After initial chemotherapy, the surgery required for this patient was challenging for 2 reasons: (1) getting the tumor out and (2) filling the defect to maintain a functional leg. In this case, I opted for a structural allograft, in which bone from a human donor is used. This bone is size-matched to the patient and is cut to the appropriate dimensions to maintain the patient’s leg length and alignment. It is then fixed to the patient’s own bone with a metal rod as well as plates and screws. This is a great option for someone so young, as it allows them to keep their own hip joint and knee joint!

Giant Cell Tumor...benign, but aggressive!This was a very interesting case of a patient with a very large giant cell tum...
08/11/2024

Giant Cell Tumor...benign, but aggressive!

This was a very interesting case of a patient with a very large giant cell tumor of the tibia around the knee joint. These types of tumors are not cancerous, but they can be locally aggressive, as was seen in this case. It caused significant expansion of the bone and mass effect on important surrounding vessels and nerves.

When caught early, these can be treated with a curettage, where we scrape out the tumor and fill the defect with bone cement or bone graft. In this case, we had to remove the entire top part of the tibia. I chose to reconstruct with an allograft-prosthetic composite, whereby a size-matched allograft tibia was used in combination with a long-stem knee replacement.

I had the honor of traveling to Phoenix, AZ with my hand/upper extremity colleague, Dr. Richard Samade, this weekend to ...
08/11/2024

I had the honor of traveling to Phoenix, AZ with my hand/upper extremity colleague, Dr. Richard Samade, this weekend to present at the OneAO 2024 conference hosted by .

Dr. Samade and I have a close collaboration exploring the use of 3D printing to help improve care for our patients. He and I co-presented a talk on 3D printing in orthopedic surgery with Dr. Laurent Guiot and Dr. Denis Marcellin-Little, both veterinary orthopedic surgeons who are doing some amazing things with 3D printing in the world of small animal surgery.

It's an exciting time to be an orthopod, whether your patients are humans or animals!

This patient was suffering from metastatic renal cell carcinoma to the left femur. This was initially managed by another...
08/11/2024

This patient was suffering from metastatic renal cell carcinoma to the left femur. This was initially managed by another surgeon with a femoral rod to stabilize the bone. However, despite radiation after surgery, the tumor continued to grow.

This not only resulted in substantial bone loss, but unfortunately, the area became infected as well. Due to the significant bone loss, extensive soft tissue involvement of the tumor, and large infection burden, we elected to proceed with a hip disarticulation. This is where the entire lower limb is amputated at the level of the hip joint.

This patient recovered extremely well and is now infection free and pain free! While we often avoid amputations, there remain scenarios when it is the best option not only for cancer control but also for function.

Metastatic cancer to the pelvis around the hip joint has been the subject of a lot of surgical innovation in recent year...
08/11/2024

Metastatic cancer to the pelvis around the hip joint has been the subject of a lot of surgical innovation in recent years. Historically, this required a big, invasive surgery, usually involving a complex hip replacement prone to many complications.

This a patient in his 70s with the unfortunate history of metastatic renal cell carcinoma to the pelvis. This was causing significant hip pain and trouble walking.

I opted to use a device called Illuminoss. This is placed percutaneously through a very small incision. We call this device a "photodynamic nail." After the bony area of interest in prepared, an expandable balloon is inserted into the canal. The balloon is injected with a liquid monomer that is then exposed to blue light, causing it to harden, stabilizing the area of concern from the inside. A spiral stripe that shows up on x-rays coats the balloon to let us see in real time that everything is placed safely and filling appropriately!

The patient did quite well, and is walking without hip pain.



Anatomy is always king with oncology surgery.This is a patient in his early 60s who was unfortunately diagnosed with a m...
08/11/2024

Anatomy is always king with oncology surgery.

This is a patient in his early 60s who was unfortunately diagnosed with a merkel cell carcinoma, arising from the lymph nodes in his left groin.

This was anatomically very close to the femoral nerve and femoral vessels. To resect tumors like this appropriately without damaging any important structures, intimate knowledge of the local anatomy and diligent preparation are always essential!

The patient is now several months out from surgery and radiation, has recovered well, and is ambulating without assistive devices.

This is a young patient in her early 20s who was diagnosed with an osteosarcoma of her right distal femur. Her initial ...
16/07/2024

This is a young patient in her early 20s who was diagnosed with an osteosarcoma of her right distal femur. Her initial x-rays show an ill-defined worrisome lesion in the bottom of the femur. The MRI shows heterogenous changes in the bone that appear very distinct from the surrounding normal bone.

After receiving preoperative chemotherapy, she underwent wide resection and reconstruction with a Compress Distal Femur Replacement. This implant applies compression across the host bone-implant interface, stimulating a healing bone response. At her 18 month postoperative visit, you can see a robust hypertrophy of the bone, indicating a fantastic healing response between implant and bone. She is doing very well and is walking with a normal gait without pain!



Here are a couple snapshots of PGY3 Huy Do, PGY2 Angela Zhang, and our medical student/research fellow Omar Manzur hard ...
08/05/2024

Here are a couple snapshots of PGY3 Huy Do, PGY2 Angela Zhang, and our medical student/research fellow Omar Manzur hard at work last night helping Dr. Samade and I with one of our 3D printing research projects!

3D printing is a powerful tool we have, and we are exploring ways to use it to transform how we train residents/students, plan for surgery, educate patients, and even perform biomechanics studies!



Had a blast yesterday at Texas Health Presbyterian Hospital Dallas! I was fortunate to be a guest lecturer for Grand Rou...
02/05/2024

Had a blast yesterday at Texas Health Presbyterian Hospital Dallas! I was fortunate to be a guest lecturer for Grand Rounds for the Department of Internal Medicine in their "Radiology and General Medicine Series."

I had the privilege of giving a talk on "Bone Lesions in Older Adults," discussing differential diagnosis and diagnostic workup. We also covered some of the basics of surgical treatment in this patient population through review of some of my cases.

Internists are often on the front line when patients come in with unknown bone tumors, and it's an honor to be able to share my perspectives on these cases with team members who are so critical to their workup and care!

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