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A reconstruction with extracorporeal irradiated autograft in osteosarcoma around the knee
Author(s) -
Kim JaeDo,
Lee Gun Woo,
Chung So Hak
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21902
Subject(s) - medicine , osteosarcoma , surgery , extracorporeal , prosthesis , knee joint , tibia , survival rate , femur , retrospective cohort study , pathology
Abstract Background and Objectives An extracorporeal irradiated (ECI) autograft was first reported in Israel in 1968 for the treatment of primary malignant bone tumor. However, subsequent reports covered mostly short‐term follow up results, and the reported results of reconstruction vary from study to study. We analyze the long‐term follow up results of reconstruction using an extracorporeal irradiated (ECI) autograft in osteosarcoma around the knee. Methods We retrospectively reviewed 23 osteosarcoma patients who underwent reconstruction with ECI between December 1995 and April 2005. The 15 males and 8 females had a mean age of 21 years (range: 7–74) and a mean follow‐up of 127 months(range: 57–170). Tumors were located in the distal femur in 14 cases, and the proximal tibia in 9 cases. Pathological types were conventional in 22 cases, and parosteal in 1 case. Resection methods were osteoarticular in 18 cases and total joint in 5 cases. Eighteen cases were reconstructed with the ECI autograft and five with ECI autograft‐prosthesis composite (APC). The Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results The overall survival rate was 82.6%, and the disease‐free survival rate was 69.5%. We found 20 complications, including 6 nonunions, 5 deep infections, 4 joint instabilities, 2 fractures, 1 limb‐length discrepancy (LLD), 1 epiphyseal collapse, and 1 vessel occlusion. The average MSTS functional score was 62.6%. Conclusions Reconstruction with an extracorporeal irradiated is not recommended for osteosarcoma around the knee. J. Surg. Oncol. 2011;104:187–191. © 2011 Wiley‐Liss, Inc.