Coverage of knee-tumor-resection prostheses with free flaps

Free latissimus dorsi free flaps were used for the treatment of three patients with malignant tumors localized at the distal end of the femur. In all cases, a knee prosthesis was used after tumor resection. In two patients, the prosthesis was covered with a free latissimus dorsi flap immediately after insertion. In one patient, the exposed prosthesis that was inserted 9 months previously was also covered with a free latissimus dorsi flap. Histopathologic diagnosis of the tumors was osteosarcoma in two cases and fusiform cell sarcoma in one case. Free-tissue transfers were successful in spite of preoperative chemotherapy and/or radiotherapy. Chemotherapy was started 3 weeks postoperatively in all cases. Patients ambulated 6 weeks after surgery and knee functions were satisfactory during a 1 year follow-up.