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Extremity osteosarcoma--a Southeast Asian experience.
H C Chang1, R W H Pho, V P Kumar
1Department of Orthopaedic Surgery, Changi General Hospital, Singapore.
Annals of the Academy of Medicine, Singapore
|October 25, 2002
Summary
Limb salvage surgery for osteosarcoma effectively uses vascularised bone grafts and autoclaved tumour bone for reconstruction. This approach offers good functional outcomes and comparable survival rates to amputation.
Area of Science:
- Orthopedic Oncology
- Surgical Reconstruction
- Bone Tumors
Background:
- Osteosarcoma presents significant challenges for limb preservation.
- Limb salvage surgery aims to retain function while removing tumors.
- Vascularised bone grafts and autoclaved tumour bone are reconstructive options.
Purpose of the Study:
- To evaluate the efficacy of limb salvage in extremity osteosarcoma.
- To assess the combined use of vascularised bone grafts and autoclaved tumour bone.
- To compare outcomes of limb salvage versus amputation.
Main Methods:
- Retrospective review of 36 extremity osteosarcoma cases (1980-1999).
- Analysis of 26 limb salvage surgeries and 10 amputations.
- Detailed assessment of reconstruction methods, joint preservation, and functional outcomes.
Main Results:
- Limb salvage reconstructions utilized vascularised bone grafts and/or autoclaved tumour bone.
- Joint preservation, particularly the knee, led to 84% good/excellent functional results.
- Actuarial survival rates were 64% at 2 years and 48% at 5 years, with no significant difference between surgical groups.
Conclusions:
- Autoclaved bone is an effective alternative for bridging large defects after high-grade tumor resection.
- Limb salvage surgery provides good functional outcomes in osteosarcoma treatment.
- The choice between limb salvage and amputation did not significantly impact survival.