J Korean Orthop Assoc.  2014 Jun;49(3):244-249.

Limb Salvage Surgery Using Whole Knee Joint Allograft Reconstruction in Osteosarcoma

• Kang HG
• Kim JH
• Kim KG

Abstract

Limb salvage should be considered after complete remission in young and physically active patients with osteosarcoma. Herein we described a patient who was treated with whole knee allograft reconstruction for the clinical implications of biological reconstruction which can avoid the problems with several consecutive sessions of mega-prosthesis revision. The mid-term result of this whole knee joint allograft reconstruction showed that it provided optimal joint congruence with durable joint stability, well balanced mechanical axis without joint space narrowing, and satisfactory gait pattern.

Keyword

allograft reconstruction; whole knee joint; limb salvage surgery; osteosarcoma

MeSH Terms

Allografts*
Axis, Cervical Vertebra
Gait
Humans
Joints
Knee
Knee Joint*
Limb Salvage*
Osteosarcoma*

Figure

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  Figure 1 (A) A coronal magnetic resonance (MR) image showed an eccentric laterally located tumor of the right proximal tibia touching upward with joint cartilage and capsule. (B) A transverse view MR image showed extraosseous tumor extension to the anterior compartment. (C) Anterior-posterior plain radiograph showed bony destruction with osteolytic and sclerotic nature. (D) Lateral plain radiograph showed tumor extension to the tibial tuberosity. (E) The osteoblastic osteosarcoma was diagnosed (H&E, ×200).

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  Figure 2 (A) Photograph showing the delivered whole knee joint fresh frozen allograft. (B) Plain radiograph showed a similar bony size compare with the patient's knee. (C) Photograph illustrates the good intra-articular condition after removal of muscle and patellar bone.

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  Figure 3 Intraoperative photograph showed a stable fixed whole knee joint allograft.

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  Figure 4 Anterior-posterior (A) and lateral (B) radiographs taken 36 months after surgery bone union has been processed in the osteotomy sites.

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  Figure 5 A Coronal magnetic resonance image of both knees taken 36 months after surgery showed yet durable medial and lateral meniscus, anterior cruciate ligament, and medial joint capsule.

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  Figure 6 The patient can walk with a satisfactory gait pattern.

Reference

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