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Limb salvage in distal tibial osteosarcoma using a custom mega prosthesis
M V Natarajan1, K Annamalai, S Williams
1Madras Medical College and Research Institute, Chennai, India.
International Orthopaedics
|January 12, 2001
Summary
Limb salvage surgery using custom prosthetics can be a viable option for distal tibial osteosarcoma. This approach offers functional benefits in carefully selected patients, though oncological outcomes require monitoring.
Area of Science:
- Orthopedic Oncology
- Reconstructive Surgery
Background:
- Distal tibial osteosarcoma presents challenges for limb salvage.
- Custom endoprosthetic replacement is an alternative to amputation.
Purpose of the Study:
- To evaluate oncological and functional outcomes of limb salvage surgery for distal tibial osteosarcoma using custom endoprosthetic replacement.
Main Methods:
- Retrospective analysis of six patients with distal tibial osteosarcoma (stage IIB).
- Surgical reconstruction using custom-made distal tibial and ankle endoprostheses.
- Assessment of oncological margins and functional scores (Musculoskeletal Tumour Society).
Main Results:
- Wide margin excision achieved in three patients; marginal in two; contaminated in one.
- Two local recurrences and one case of flap necrosis with deep infection were observed.
- Patients with retained prostheses achieved a mean functional score of 24.3/30.
Conclusions:
- Limb salvage surgery with custom endoprosthetic replacement is feasible for select distal tibial osteosarcoma cases.
- Careful patient selection and monitoring are crucial for optimizing oncological and functional results.