Prosthetic limb salvage surgery for bone and soft tissue tumors around the knee

• Published in: Oncology reports Vol. 28; no. 6; pp. 1984 - 1990
• Main Authors: NIIMI, RUI, MATSUMINE, AKIHIKO, HAMAGUCHI, TAKAHIKO, NAKAMURA, TOMOKI, UCHIDA, ATSUMASA, SUDO, AKIHIRO
• Format: Journal Article
• Language: English
• Published: Athens D.A. Spandidos 01-12-2012; Spandidos; Spandidos Publications UK Ltd
• Subjects: Adolescent; Adult; Aged; Amputation; Artificial Limbs; Biological and medical sciences; Bone cancer; Bone Neoplasms - mortality; Bone Neoplasms - surgery; Chemotherapy; Child; Chondrosarcoma - mortality; Chondrosarcoma - surgery; complications; Diseases of the osteoarticular system; Female; Females; Femur - pathology; Femur - surgery; function; Giant Cell Tumors - mortality; Giant Cell Tumors - surgery; Histiocytoma, Malignant Fibrous - mortality; Histiocytoma, Malignant Fibrous - surgery; Humans; Knee; Knee - pathology; Knee - surgery; knee joint; Knee Joint - pathology; Knee Joint - surgery; Knee Prosthesis; Leg - pathology; Leg - surgery; Limb Salvage; Male; Medical sciences; Metastasis; Middle Aged; Neurological disorders; Osteosarcoma - mortality; Osteosarcoma - surgery; Patients; Prostheses; reconstruction; Retrospective Studies; Sarcoma; Soft Tissue Neoplasms - mortality; Soft Tissue Neoplasms - surgery; Surgery; Survival Rate; Tibia - pathology; Tibia - surgery; Titanium alloys; Treatment Outcome; Tumors; Tumors of striated muscle and skeleton; Young Adult; Knee; Human; Sarcoma; complications; Prosthesis; Diseases of the osteoarticular system; knee joint; Soft tissue sarcoma; Malignant tumor; Cancerology; Osteosarcoma; Surgery; Limb; function; Complication; reconstruction; Bone; Salvage treatment; Cancer
• ISSN: 1021-335X; 1791-2431
• DOI: 10.3892/or.2012.2021

In this study, we analyzed long-term survival, limb function and associated complications after prosthetic limb salvage treatment in patients with bone and soft tissue tumors around the knee joint. A total of 63 patients treated with prosthetic limb salvage surgery around the knee were reviewed. The bone tumors involved the distal femur in 45 patients, the proximal tibia in 14 patients and the soft tissue tumors of the proximal lower leg in 4 patients. The median follow-up period after the first operation was 8.0 years. The medical records of the patients, surgical reports, radiographs and histological specimens were retrospectively reviewed. The 5-year overall survival rate was 63.2% in the patients with distal femur tumors and 86.2% in those with tumors of the proximal lower leg. The 5-year prosthetic survival rate was 72.8% in the distal femur and 74.6% in the proximal lower leg. The mean functional score according to the scoring system of the Musculoskeletal Tumor Society (MSTS) was 81% in the patients with distal femur tumors and 82% in the patients with proximal lower leg tumors. Post-operative complications occurred in 27 patients. Limb salvage surgery is considered to be an effective treatment option. However, the high complication rate is a major concern for prosthetic replacement. Future improvements of prostheses are very important.