Joint-preservation surgery for pediatric osteosarcoma of the knee joint

Takeuchi, Akihiko; Yamamoto, Norio; Hayashi, Katsuhiro; Matsubara, Hidenori; Miwa, Shinji; Igarashi, Kentaro; Yokogawa, Noriaki

doi:10.1007/s10555-019-09835-z

“…Biological reconstruction with vascularized bular graft [9], treated autologous bone [10][11], allograft combined bula allograft [12] and segmental transport [13] would be acceptable techniques for this kind of patients. But, these reconstruction techniques would be usually associated with frequent complications, such as graft resorption, nonunion, pathological fractures and insu cient demand of weight-bearing [14]. Three-dimensional-printed segmental prosthesis with the advantages of high shape compatibility and osteointegration capacity of the porous surface has gradually been popular for the JSLSS.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-Dimensional-Printed Prothesis for Children with Osteosarcoma in Distal Femur

Cai

¹

,

Zhang

²

,

Zhang

³

et al. 2020

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0

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Purpose The purpose of this study was to introduce the surgical technique and functional outcome of joint-sparing limb salvage surgery with metaphyseal osteotomy by dependent design of three-dimensional printed prothesis for children with osteosarcoma in distal femur.Methods Between 2012 to 2019, we performed twelve joint sparing limb salvage surgeries (JSLSS) with metaphyseal osteotomy for the children of osteosarcoma in the distal femur with our dependent design of 3D-printed guided plate and prothesis. The clinical assessment including resection margin, limb-length discrepancy, orthopaedic complications and functional outcome would be analyzed.Results The mean operation time for JSLSS was 107.6 minutes and the average blood loss was 194.5ml with the dependent design of 3D-printed prosthesis. With the assistance of guide plate, the mean margin of the osteosarcoma from the epiphyseal plate was 1.6 cm and the mean limb-length discrepancy was 2.2 cm with maximum follow-up period of seven years (mean 45.3 months, range 12-84 months). All the patients could bend their knee through >90° flexion, achieved similar results for ROMs in 6DOF during gait compared with normal data of Chinese knees, and the mean MSTS score was 94.7 for the patients with JSLSS. One patient had a superficial infection and there was one patient of local recurrence happened during the follow-up with the necrosis rate less than 90% by preoperative chemotherapy. None aseptic loosening happened in distal femur for the patients in this group with dependent design of 3D-printed prosthesis.Conclusion Joint-sparing limb salvage surgery by metaphyseal osteotomy with the dependent design of 3D-printed prosthesis and guide plate would be a good choice for the children with osteosarcoma in distal femur.

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“…Biological reconstruction with vascularized bular graft [9], treated autologous bone [10][11], allograftcombined bula allograft [12]and segmentaltransport [13] would be acceptable techniques for this kind of patients. But, these reconstruction techniques would be usually associated with frequent complications, such as graft resorption,nonunion, pathological fractures and insu cient demand of weight-bearing [14]. Three-dimensional-printed segmental prosthesis with the advantages of high shape compatibility and osteointegration capacity of the porous surface has gradually been popular for the JSLSS.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-dimensional-printed Prothesis for Children With Osteosarcoma in Distal Femur

Cai

¹

,

Zhang

²

,

Zhang

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Purpose The purpose of this study was to introduce the surgical technique and functional outcome of joint-sparing limb salvage surgery with metaphyseal osteotomy by dependent design of three-dimensional printed prothesis for children with osteosarcoma in distal femur.Methods Between 2012 to 2019, we performed twelve joint sparing limb salvage surgeries (JSLSS) with metaphyseal osteotomy for the children of osteosarcoma in the distal femur with our dependent design of 3D-printed guided plate and prothesis. The clinical assessment including resection margin, limb-length discrepancy, orthopaedic complications and functional outcome would be analyzed.Results The mean operation time for JSLSS was 107.6 minutes and the average blood loss was 194.5ml with the dependent design of 3D-printed prosthesis. With the assistance of guide plate, the mean margin of the osteosarcoma from the epiphyseal plate was 1.6 cm and the mean limb-length discrepancy was 2.2 cm with maximum follow-up period of seven years (mean 45.3 months, range 12-84 months). All the patients could bend their knee through >90° flexion, achieved similar results for ROMs in 6DOF during gait compared with normal data of Chinese knees, and the mean MSTS score was 94.7 for the patients with JSLSS. One patient had a superficial infection and there was one patient of local recurrence happened during the follow-up with the necrosis rate less than 90% by preoperative chemotherapy. None aseptic loosening happened in distal femur for the patients in this group with dependent design of 3D-printed prosthesis.Conclusion Joint-sparing limb salvage surgery by metaphyseal osteotomy with the dependent design of 3D-printed prosthesis and guide plate would be a good choice for the children with osteosarcoma in distal femur.

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“…Amitani et al then proposed a limb salvage procedure that preserves the knee joint [10]. In a recent study, Takeuch et al called it joint-preserving surgery (JPS) [11]. In the past decade, our team has been studying and improving this surgical approach [12][13][14][15], and because of the rise of the patient's age and the closure of the physis, we named it jointpreservation limb salvage.…”

Section: Discussionmentioning

confidence: 99%

Comparative Observation of Two Types of Limb Salvage Surgery on Limb Function and Quality of Life in Patients With Knee Joint Osteosarcoma

Hou¹,

Bai²,

Xu³

et al. 2020

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BackgroundWe compared the effects of two surgical procedures on limb function and quality of life in patients with osteosarcoma in the knee.MethodsThis retrospective study evaluated the postoperative outcomes of patients treated with JPLS and JPRS for osteosarcoma around the knee between November 2000 and December 2019. All patients were followed up for at least one year. Patients' lower extremity function, knee function, and quality of life were evaluated during follow-up using the MSTS score, IKDC score, and SF-36 score.ResultsAll 38 patients received a successful operation, and all incisions healed in one stage after surgery. At 12 months after the operation, the MSTS score in the prosthetic-replacement group (22.79±5.22) was lower than that in the joint-preservation group (27.05±1.62)(P=0.002). The IKDC score was lower in the prosthetic-replacement group (59.89±11.22) than in the joint-preservation group (76.84±9.42)( P <0.001). After 12 months, the SF-36 scores of physiological and social function in the joint-preserving group were higher than those in the prosthetic-replacement group (P <0.05), and there were no significant differences among the other indexes (P >0.05). Comparing the distribution of each item in the MSTS and IKDC scoring criteria between the joint-preservation and the prosthetic-replacement group revealed that the limb function, pain, satisfaction, support assistance, and the walking and gait of the joint preservation group were superior to those of the prosthetic-replacement group (P < 0.05). There was no significant difference in knee flexion between the two groups (P > 0.05). However, the joint preservation group was superior to the prosthesis replacement group in terms of pain, swelling, twisting, softening of the leg, movement downstairs, sitting up from a chair, kneeling, squatting, running straight forward, jumping up with the injured leg and landing, and quickly stopping or starting (P < 0.05).ConclusionCompared with joint-prosthesis replacement surgery, joint-preservation limb salvage leads to better joint function and quality of life. To improve the limb function and quality of life of patients with long-term survival osteosarcoma, joint-preservation limb salvage should be carried out according to the principles of Operation Indication, neoadjuvant and effective chemotherapy.

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Joint-preservation surgery for pediatric osteosarcoma of the knee joint

Cited by 65 publications

References 69 publications

Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-Dimensional-Printed Prothesis for Children with Osteosarcoma in Distal Femur

Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-Dimensional-Printed Prothesis for Children with Osteosarcoma in Distal Femur

Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-dimensional-printed Prothesis for Children With Osteosarcoma in Distal Femur

Comparative Observation of Two Types of Limb Salvage Surgery on Limb Function and Quality of Life in Patients With Knee Joint Osteosarcoma

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