Function and complications after ablative and limb-salvage therapy in lower extremity sarcoma of bone.
OBJECTIVE
The functional results and the complications after several limb-saving and ablative treatments because of lower extremity bone sarcoma were evaluated.


METHODS
Seventy-seven surviving patients were evaluated according to the MSTS (American Musculoskeletal Tumor Society) functional rating system. Fifty-two patients had limb-saving and 25 had ablative therapy. Median follow-up was 97 months in the limb-saving group and 112 months in the ablative group.


RESULTS
Functional results in the limb-saving group were significantly better than in the ablative group (P = 0.0001). Functional results in patients with tumors about the knee joint were significantly better (P = 0.0064) after limb-saving surgery (i.e., endoprosthesis, knee arthrodesis, or rotationplasty) compared to functional results after ablative surgery (i.e., hip or knee disarticulation or above-the-knee amputation). Complications were 3 times more common after limb-salvage procedures and 4 times more common after endoprosthetic reconstructions compared to after ablative procedures. Complications after limb-saving therapy were fewest in tumors about the knee joint. In 3/28 patients, the endoprosthetic reconstruction had to be converted to an amputation.


CONCLUSIONS
Functional results were significantly better after limb-saving compared to after ablative therapy. Complications, however, were more common after limb-saving therapy.
Renard
A J
AJ
Department of Orthopaedics, Nijmegen University Hospital, Nijmegen, The Netherlands.
Veth
R P
RP
Schreuder
H W
HW
van Loon
C J
CJ
Koops
H S
HS
van Horn
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000704:Analysis of Variance; D001174:Arthrodesis; D019643:Arthroplasty, Replacement; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002813:Chondrosarcoma / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007866:Leg / Q000502:physiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D012516:Osteosarcoma / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012512:Sarcoma, Ewing / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome