J Korean Bone Joint Tumor Soc.  2011 Dec;17(2):79-86. 10.5292/jkbjts.2011.17.2.79.

Outcome of Tumor Prosthetic Reconstruction in Osteosarcoma Patient

• Kim JD
• Kim CK
• Chung SH

• KMID: 1444793
• DOI: http://doi.org/10.5292/jkbjts.2011.17.2.79

Abstract

PURPOSE
Modular tumor prosthesis is the most popular recontructive modality after resection of malignat tumor in extremity. Complications and survival of tumor prosthesis reconstruction are well-known. however, reports on the long-term outcome of tumor prosthesis in osteosarcoma patientss are scarece.
MATERIALS AND METHODS
In 158 cases as diagnosed as osteosarcoma from feburary 1989 to December 2006 in a single cancer center. We retrospectively reviewd 48 osteosarcoma patients who under went tumor prosthetic reconstruction. Mean follow up preiod was 75.6 months (range; 60 to 179 months). There were 28 males, 20 females and mean age was 22.4 years (range; 11-71). Pathologic subtypes were conventional central osteosarcoma in 46 cases and periosteal in 2 cases. The location of the tumor was proximal tibia (26 cases), distal femor (20 cases), femor diaphysis (1 case), and tibia diaphysis (1 case). In 41 cases built-up-type tumor prosthesis have been used and 7 cases expansion-type tumor prosthesis have been used. We used Musculoskeletal tumor society (MSTS) grading system to asses post operation function, and we analyzed survival rate of patient and tumor prosthesis and complication.
RESULTS
The overall survival rate was 77.7% and disease free survival rate was 68.9%. The survival rate of tumor prosthesis was 73%, in last follow up tumor prosthesis has been removed in 12 cases. All of them, 17 complications occurred, which included infection in 16 cases, Periprosthetic Fracture and Loosening of tumor prosthesis in 4 cases, articular instability in 4 cases. MSTS functional score was 74.1% in post operation.
CONCLUSION
In long term follow up result, Primary tumor prosthesis -a reconstruction method after a wide extensional resecion of a bone tumor- can be a effective treatment method in asepect of survival rate, functional assesment and complication.

Keyword

osteosarcoma; tumor prosthesis; limb salvage

MeSH Terms

Diaphyses
Disease-Free Survival
Equidae
Extremities
Female
Follow-Up Studies
Humans
Limb Salvage
Male
Osteosarcoma
Periprosthetic Fractures
Prostheses and Implants
Retrospective Studies
Survival Rate
Tibia

Figure

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  Figure 1. K-M graph for survival rate of the distal femoral and the proximal tibia prosthesis.

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  Figure 2. 19 years-old male patient. (A, B) Preoperative radiograph show radiolucent bony lesion in left distal femur and (C) inhomogenous low signal intensity of mass and surrounging muscles. The result of insional bouposy was grade 2B osteosarcoma.

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  Figure 3. (A, B) After Wide excision, resconstruction with Mutars Prosthesis. 15 months follow up infection was occurred.

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  Figure 4. (A, B) After removal of prosthesis, athrodesis was done using endernail.

Reference

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