[Overlooked osteosarcoma in a patient undergoing total knee arthroplasty. A case report].
A 72-year-old woman presented with pain, swelling, and decreased range of motion of the left knee joint after total knee arthroplasty in 2005. We performed standard x-rays, which were highly suspicious for an osteosarcoma of the distal femur; this was proven by open biopsy. Retrospectively, the x-rays taken before implantation of the prosthesis showed suspicious findings. Because the femur was tumor-contaminated, with the intramedullary adjustment far-reaching proximally, a limb salvage procedure was no longer possible. To improve function, we decided to perform a stump-lengthening procedure using a special implant. With regard to the dismal consequences, we recommend that every suspicious finding before an elective surgical procedure be examined with further diagnostics and, if necessary, histological confirmation.
Balke
M
M
Klinik und Poliklinik für Allgemeine Orthopädie, Universitätsklinik Münster, Albert-Schweitzer-Strasse 33, 48149, Münster. maurice.balke@web.de
Vieth
V
V
Ahrens
H
H
Streitbürger
A
A
Gosheger
G
G
Hardes
J
J
D000368:Aged; D000671:Amputation, Surgical; D019645:Arthroplasty, Replacement, Knee; D001186:Artificial Limbs; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D005260:Female; D005266:Femoral Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D020360:Neoadjuvant Therapy; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery*; D012516:Osteosarcoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D010521:Periosteum / Q000473:pathology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed