Extensor Mechanism Allograft in Osteosarcoma of the Patella

Abstract

Case: A 24-year-old female diagnosed with fibroblastic osteosarcoma of the patella underwent a total patellectomy and surgical reconstruction with a large bone–tendon allograft of the extensor mechanism and adjuvant chemotherapy. At 5 years' postoperative, the patient has adequate disease control and excellent joint function. Conclusions: Reconstruction with an extensor mechanism allograft is an appropriate alternative for patients with malignant patella tumors without tumor contamination of the joint, allowing for satisfactory knee function and disease control.

Knee Extensor Apparatus Reconstruction with Allograft after Patellar Resection: A Case Report

“…Some case reports and technical notes so far published regard lesions confined to the anterior knee or associated with distal femur or proximal tibia that required megaprosthetic reconstructions. Several solutions have been proposed and described through the last decades, including systemic and prosthetic augments [3,4], autologous tissues [5], and allografts [4,[6][7][8]. Reconstructive solutions include biological [3,4,[6][7][8] and nonbiological implants [4,5], both of them with their pros and cons.…”

“…Several solutions have been proposed and described through the last decades, including systemic and prosthetic augments [3,4], autologous tissues [5], and allografts [4,[6][7][8]. Reconstructive solutions include biological [3,4,[6][7][8] and nonbiological implants [4,5], both of them with their pros and cons. Although synthetic augments often have good mechanical properties, they lack bio-integrative properties, and their performances may decrease over the years.…”

“…Three years after surgery, the authors obtained good functional results with a graft consisting of a quadriceps tendon, a patella with a patellar tendon, and the medial and lateral retinacula. In 2019, Gómez-Palomo et al [ 8 ] performed a similar reconstruction for a 24 year-old case with a patellar osteosarcoma. Within five years after surgery, their patient highlighted good functional and clinical outcomes.…”

Metastatic patellar bone tumor due to gastric cancer resembling a primary or secondary aneurysmal bone cyst: A case report

“…A tendon graft was not necessary as reported [ 17 , 19 ]. Furthermore, in our country, allograft is challenging [ 16 ]. Reinforcement with fascia grafts was reasonable for small defects.…”

Patellar reconstruction in primary total knee arthroplasty using bone chips from routine cuts: A case report and review of literature

“…Total patellectomy was a prevalent procedure in past decades, primarily employed to address conditions such as chondromalacia, patellofemoral arthritis, patellofemoral dislocation, and comminuted fractures[ 1 - 5 ]. In contemporary times, an enhanced understanding of the patella's role in biomechanical knee function, coupled with advancements in surgical techniques, has relegated this radical surgery to a salvage option[ 6 ]. Nonetheless, patients with patellectomy sequelae persist or when there is no alternative to avoid patellectomy, as is the case with malignant tumors.…”