[Endoprosthetic reconstruction after wide resection of primary bone tumor around the knee].
OBJECTIVE
To evaluate the effect and complication of the endoprosthetic reconstruction after wide resection of primary bone tumor around the knee.


METHODS
The retrospective analysis was performed on 83 patients undergoing the prosthetic reconstruction after the resection of the primary tumor around the knee between December 1995 and December 2005. All the diagnoses were pathologically confirmed (58 patients with osteosarcoma, 2 with osteosarcomatosis, 1 with parosteal osteosarcoma, 4 with malignant fibrous histiocytoma, 13 with giant cell tumor of bone, 1 with leiomyosarcoma, 2 with Ewing's sarcoma, 2 with chondrosarcoma). The distal femur group was involved in 44 patients, proximal tibia group in 34 (including 33 deficit in proximal tibia, 1 deficit both in proximal tibia and distal femur), total femur replacement group in 5. After operation, the Musculoskeletal Tumor Society (MSTS) score was used to evaluate the recovery of their corresponding functions.


RESULTS
The follow-up for 12 - 130 months (with a median of 41 months) revealed that the 3-year survival rate of the prosthesis was 88.2%, and the 5-year survival rate was 82.1%. As for the complications, local recurrence developed in 6 patients, peri-prosthesis infection in 2 patients, aseptic loosening in 2 patients. The mean MSTS core was 25.0 (19.0 - 29.0) in the distal femur group, 24.4 (17.0 - 28.0) in the proximal tibia group, and 19.0 (16.0 - 21.0) in the total femur replacement group. As to the statistical analysis, the function of the former two groups were greater than the latter one (F = 11.666, P < 0.001), however, there was no significant difference between the former 2 groups (F = 0.813, P = 0.370).


CONCLUSIONS
Taken together, the tumor prosthesis gives a satisfactory functional outcome after the tumor around the knee is removed with a lower incidence of complication.
Li
Wei-xu
WX
Department of Orthopaedics, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China. liweixu@163.com
Ye
Zhao-ming
ZM
Yang
Di-sheng
DS
Tao
Hui-min
HM
Lin
Nong
N
Yang
Zheng-ming
ZM
D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome