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Limb Salvage and Reconstruction Options in Osteosarcoma.
Samuel Z Grinberg1, Abigail Posta2, Kristy L Weber3
1Medical Student, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
Advances in Experimental Medicine and Biology
|June 3, 2020
Summary
Limb-salvage surgery (LSS) is the preferred treatment for extremity bone sarcomas, prioritizing limb function and quality of life. Current LSS techniques offer good survival rates for osteosarcoma patients.
Area of Science:
- Orthopedic oncology
- Surgical oncology
- Musculoskeletal oncology
Background:
- Limb-salvage surgery (LSS) is now the standard for extremity bone sarcomas, replacing amputation.
- Advances in chemotherapy, imaging, and surgical techniques have improved outcomes.
- LSS aims to preserve limb function and quality of life without compromising survival or local tumor control.
Purpose of the Study:
- To provide a comprehensive overview of LSS for extremity osteosarcoma.
- To detail various reconstruction techniques and their associated complications.
- To discuss LSS across multiple anatomic locations in the extremities.
Main Methods:
- Focus on LSS for extremity osteosarcoma.
- Discussion of common reconstruction techniques: endoprostheses, allografts, vascularized fibular autografts, and allograft prosthetic composites (APC).
- Detailed review of potential complications: infection, local recurrence, graft fracture, implant failure, and nonunion.
Main Results:
- LSS is performed in 80-95% of extremity osteosarcoma cases.
- Five-year survival rates for extremity osteosarcoma patients are now 60-75% with LSS.
- LSS maximizes limb functionality while maintaining survival and local tumor control.
Conclusions:
- LSS is a highly effective treatment for extremity osteosarcoma.
- Understanding reconstruction options and potential complications is crucial for successful outcomes.
- This approach significantly improves patient quality of life and oncologic results.
Keywords:
AllograftAllograft prosthesis compositeEndoprosthesisFemurInfectionLimb salvage surgeryLocal recurrenceLooseningNonunionOsteosarcomaWear
