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[Surgery in «around the knee» bone tumors].

Jean-Camille Mattei1, Georges Curvale1, Alexandre Rochwerger1

  • 1Hôpital de la Conception, Service d'orthopédie-traumatologie du Pr-Curvale, 147, boulevard Baille, 13005 Marseille, France.

Bulletin Du Cancer
|July 1, 2014
PubMed
Summary

Malignant bone tumors in the distal femur and proximal tibia are treated with limb-sparing surgery and total knee arthroplasty. Advances in chemotherapy and surgical techniques improve outcomes and minimize amputations for these rare, complex cancers.

Keywords:
kneeosseousreconstructionresectionsarcomas

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Area of Science:

  • Orthopedic oncology
  • Surgical reconstruction
  • Bone cancer research

Context:

  • Primary malignant bone tumors frequently occur in the distal femur and proximal tibia.
  • Osteosarcoma and Ewing sarcoma are the most common types.
  • Multidisciplinary care is essential due to rarity and treatment complexity.

Purpose:

  • To review current management strategies for primary malignant bone tumors in the distal femur and proximal tibia.
  • To highlight the role of total knee arthroplasty in reconstruction after tumor resection.
  • To discuss surgical challenges, outcomes, and the necessity of specialized sarcoma care.

Summary:

  • Limb-sparing surgery combined with total knee arthroplasty is the gold standard for reconstructing the knee after resection of distal femur or proximal tibia malignant bone tumors.
  • Surgical techniques focus on achieving stable fixation with long stems and managing soft tissues, including the extensor apparatus.
  • Despite improved functional and oncologic results, these complex surgeries often require revision due to the young age and high functional demands of patients.

Impact:

  • Minimizes amputation rates through advanced surgical and chemotherapeutic protocols.
  • Establishes total knee arthroplasty as an effective and durable reconstructive option.
  • Emphasizes the critical need for specialized sarcoma teams and network-organized care for optimal patient outcomes.