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[Resection-reconstruction of the knee for bone tumor (author's transl)]
Abstract:
The authors report 17 cases of primary tumors of the knee treated by wide resection, removing "en bloc" the entire epiphysis in 14 cases and in the remaining 3 most of the epiphysis. The series consisted of 8 giant cell tumors of which 6 were followed for between three and fifteen years, and for 9 tumors of moderate malignancy amongst which 1 fibrosarcoma, 1 parosteal osteosarcoma and 3 cartilaginous tumors which were followed between five and fourteen years. All were free of metastatic spread except 1 fibrosarcoma whose resection was debatable. Arthrodesis was carried out on all but 2 patients received prosthesis. The arthrodeses were made by autogenous grafts protected in 11 cases by intramedullary rod, in 1 case by a plate, and in 3 cases by both. The series contains one amputation and three fractures necessitated secondary grafting with replacement of rod in two cases. The results are analysed in carcinological and technical shemes. The value of resection and the importance of grafting over the arthrodesis are emphasised. In the long term, resection-arthrodesis means the conservation of a stable and functional limb, permitting an active life one year postoperatively. Massive prosthesis are only exceptionally indicated.