A Preliminary Evaluation of Limb Salvage Surgery for Osteosarcoma around Knee Joint

Xing Wu, Zheng-dong Cai, Zheng-rong Chen, Zhen-jun Yao, Guang-jian Zhang, Rossella Rota
2012 PLoS ONE  
Objective: To evaluate the effectiveness and drawbacks of diversified procedures of limb salvage surgery (LSS), providing a reference of rational surgical criterion of LSS. Methods: Fifty eight patients with stage IIB extremity osteosarcoma around knee joint area between 1992 and 2002 were studied retrospectively. Among them, 43 patients were treated by LSS followed by reconstruction. Reconstruction approaches included re-implantation of irradiation-devitalized tumor bone (n = 12),
more » ... evitalized tumor bone (n = 8), prosthetic replacement (n = 11), allograft transplantation (n = 8) and vascularized fibula autograft implantation (n = 4). Amputations were performed in 15 patients. Patients were followed up for 6-16 years. Results: There were no significant difference between LSS and amputation groups regarding disease free survival and local recurrence rates. The actuarial 5-year continuous disease free survival and local recurrence rate were 30.0% and 25.0% in patients of devitalized LSS group, whereas those were 56.5% and 8.7% in patients of non-devitalized reconstruction group. The complication rate was significantly higher in LSS group compared to amputation group (P = 0.003). Conclusion: LSS with non-devitalized procedures is the optimal treatment for osteosarcoma around knee joint area. Prosthesis implantation is the preferred option for bone reconstruction following LSS. Prevention and treatment of postoperative complications should be paid more attention to get good long-term outcomes of surgery.
doi:10.1371/journal.pone.0033492 pmid:22457768 pmcid:PMC3311641 fatcat:zuw2x7uxg5b27fu67ingi6rl7e