Analysis of the efficacy and prognosis of limb-salvage surgery for osteosarcoma around the knee.
OBJECTIVE
Limb-salvage surgery has become the standard of care for extremity osteosarcoma. In this study, we investigated the survival and functional outcomes of patients with osteosarcoma around the knee who were treated with limb-salvage surgery.


METHODS
We retrospectively reviewed the clinical data for 120 patients with osteosarcoma around the knee who were treated with limb-salvage surgery between 1998 and 2008. The sample included 75 males and 45 females. The mean age of the patients was 18.9 years. Osteosarcoma was diagnosed in the distal femur in 78 patients and in the proximal tibia in 42 patients. Statistical analyses were conducted to process and record the patient data and analyse the surgery's efficacy, prognosis and survival rates.


RESULTS
All patients were followed for 6-144 months (mean of 56.8 months). The overall 5-year survival rate was 61.8%. Lung metastasis developed in 31 patients. Local recurrence developed in 9 patients. The average Musculoskeletal Tumor Society Score (MSTS) was 25.5 points on a 30-point scale. Sixteen patients underwent prosthesis revision and twelve patients underwent amputation. The overall survivorship of the prosthesis based on Kaplan-Meier estimates was 77% at five years and 71% at ten years. There was a higher incidence of extensor lag for the patients with osteosarcoma in the proximal tibia than for those with osteosarcoma in the distal femur (P < 0.01).


CONCLUSIONS
Treating osteosarcoma around the knee with limb-salvage surgery can preserve most of the knee's functionality. Attention must be paid to prevent the relatively high incidence of postoperative complications.
Musculoskeletal Tumor Center, Department of Orthopaedic Surgery, First Affiliated Hospital of Sun Yat-Sen University, 14th floor, # 58, Zhongshan 2nd Road, Guangzhou 510080, PR China.
P X
PX
Tan
B C
BC
Yong
J
J
Wang
G
G
Huang
J Q
JQ
Yin
C Y
CY
Zou
X B
XB
Xie
Q L
QL
Tang
J N
JN
Shen
D000293:Adolescent; D001859:Bone Neoplasms / Q000401:mortality / Q000601:surgery*; D002681:China / Q000453:epidemiology; D005260:Female; D005269:Femur; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D012516:Osteosarcoma / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013977:Tibia; D013997:Time Factors; D016896:Treatment Outcome