title: A preliminary evaluation of limb salvage surgery for osteosarcoma around knee joint.
abstract: OBJECTIVE
  To evaluate the effectiveness and drawbacks of diversified procedures of limb salvage surgery (LSS), providing a reference of rational surgical criterion of LSS.
  
  
  METHODS
  Fifty eight patients with stage IIB extremity osteosarcoma around knee joint area between 1992 and 2002 were studied retrospectively. Among them, 43 patients were treated by LSS followed by reconstruction. Reconstruction approaches included re-implantation of irradiation-devitalized tumor bone (n = 12), autoclaving-devitalized tumor bone (n = 8), prosthetic replacement (n = 11), allograft transplantation (n = 8) and vascularized fibula autograft implantation (n = 4). Amputations were performed in 15 patients. Patients were followed up for 6-16 years.
  
  
  RESULTS
  There were no significant difference between LSS and amputation groups regarding disease free survival and local recurrence rates. The actuarial 5-year continuous disease free survival and local recurrence rate were 30.0% and 25.0% in patients of devitalized LSS group, whereas those were 56.5% and 8.7% in patients of non-devitalized reconstruction group. The complication rate was significantly higher in LSS group compared to amputation group (P = 0.003).
  
  
  CONCLUSIONS
  LSS with non-devitalized procedures is the optimal treatment for osteosarcoma around knee joint area. Prosthesis implantation is the preferred option for bone reconstruction following LSS. Prevention and treatment of post-operative complications should be paid more attention to get good long-term outcomes of surgery.
authors.affiliation: Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China. wuxinggood@163.com
authors.forename: Xing
authors.initials: X
authors.lastname: Wu
authors.forename: Zheng-Dong
authors.initials: ZD
authors.lastname: Cai
authors.forename: Zheng-Rong
authors.initials: ZR
authors.lastname: Chen
authors.forename: Zhen-Jun
authors.initials: ZJ
authors.lastname: Yao
authors.forename: Guang-Jian
authors.initials: GJ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005121:Extremities / Q000601:surgery*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D055815:Young Adult