Local tendon transfer for knee extensor mechanism reconstruction after soft tissue sarcoma resection

Area of Science:

• Orthopedic Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Soft tissue sarcomas often necessitate extensive quadriceps resection, posing reconstruction challenges.
• Hamstring tendon transfer is a reconstructive option for quadriceps defects.
• Evaluating outcomes and risk factors is crucial for optimizing patient results.

Purpose of the Study:

• To assess the outcomes of hamstring transfer for quadriceps reconstruction post-soft tissue sarcoma resection.
• To identify risk factors impacting functional results and complications.

Main Methods:

• Retrospective review of 43 patients undergoing hamstring transfer after sarcoma resection.
• Assessment of range of motion, muscle strength, and plantar pressure distribution.
• Evaluation of patient satisfaction, quality of life, and Karnofsky Index.

Main Results:

• Biceps tendon transfer was used in 74% of cases; combined transfers in 26%.
• Significant quadriceps resection (≥75%) occurred in 91% of patients.
• Mean follow-up was 61 months; 40% of patients had physical examination, showing good knee flexion and extension strength, with altered plantar pressure distribution.

Conclusions:

• Hamstring transfer is a viable technique for quadriceps reconstruction after extensive tumor resection.
• Combined hamstring transfers yield comparable functional outcomes to biceps alone but are associated with higher complication rates.
• Surgical technique, patient age, and resection extent significantly influence functional outcomes and complications.