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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 10, 1366-1372.
doi: 10.1302/0301-620X.91B10.22212  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Biological reconstruction after resection of bone tumours around the knee

LONG-TERM FOLLOW-UP

Y. Y. Abed, MD, Clinical Fellow1; G. Beltrami, MD, Orthopaedic Surgeon2; D. A. Campanacci, MD, Orthopaedic Surgeon2; M. Innocenti, MD, Hand and Microsurgeon3; G. Scoccianti, MD, Orthopaedic Surgeon2; and R. Capanna, MD, Orthopaedic Surgeon2

1 Musculoskeletal Oncology Unit Mansoura University, , Gomhoria Street 60, Mansoura, 35516, Egypt.
2 Department of Orthopaedic Oncology
3 Reconstructive Microsurgery Unit, Azienda Ospedaliero-Universitaria Careggi, C. T. O. Largo Palagi 1, Firenze, 50139, Italy.

Correspondence should be sent to Dr G. Beltrami; e-mail: giovannibeltrami{at}virgilio.it

We reviewed 25 patients who had undergone resection of a primary bone sarcoma which extended to within 5 cm of the knee with reconstruction by a combination of a free vascularised fibular graft and a massive allograft bone shell. The distal femur was affected in four patients and the proximal tibia in 21. Their mean age at the time of operation was 19.7 years (5 to 52) and the mean follow-up period 140 months (28 to 213). Three vascularised transfers failed. The mean time to union of the fibula was 5.6 months (3 to 10) and of the allograft 19.6 months (10 to 34). Full weight-bearing was allowed at a mean of 21.4 months (14 to 36). The mean functional score at final follow-up was 27.4 (18 to 30) using a modfied 30-point Musculoskeletal Tumour Society rating system. The overall limb-salvage rate was 88%. The results of our study suggest that the combined use of a vascularised fibular graft and allograft is of value as a limb-salvage procedure for intercalary reconstruction after resection of bone tumours around the knee, especially in skeletally immature patients.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General