Endoprosthetic replacement with preservation of the epiphysis for proximal tibial reconstruction after osteosarcoma resection in children: a case report.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Osteosarcoma*/surgery ; Tibia*/surgery ; Tibia*/diagnostic imaging ; Bone Neoplasms*/surgery ; Epiphyses*/surgery ; Limb Salvage*/methods; Humans ; Male ; Child ; Plastic Surgery Procedures/methods ; Knee Joint/surgery ; Knee Joint/diagnostic imaging ; Knee Joint/physiopathology ; Treatment Outcome

Background: Limb salvage surgery is an important method for treating malignant tumors of the bone involving the adjacent parts of the major joints in children. This technique allows for preservation of limb function, especially in the lower limb. However, the reconstruction of the proximal end of the tibia after removing the tumor mass with a rational scale to preserve the total knee joint and reduce limb length discrepancy presents a challenge.
Case Presentation: We present a case of osteosarcoma of the proximal tibia. After being treated with an extended tumor resection, the proximal tibia of the child was restructured using endoprosthetic replacement with epiphyseal preservation. This procedure preserves the entire articular surface and growth plate of the knee joint of the affected limb and provides a feasible alternative protocol for retaining the function and growth potential of the affected limb. The patient remained disease-free and normal limb motor function was observed during the 3.5 year follow-up since the initial surgery.
Conclusions: Preservation of the epiphysis enabled our patient to perform better limb function after limb-saving surgery as a result of his undamaged knee joint and minimized limb-length discrepancy. We believe that endoprosthetic replacement with preservation of the epiphysis can provide the best strategy for reconstruction after resection of focal malignant tumors in long bones without epiphytic involvement.
(© 2024. The Author(s).)

Clin Orthop Relat Res. 1991 Jan;(262):108-18. (PMID: 1984905)
BMC Musculoskelet Disord. 2018 Jun 6;19(1):185. (PMID: 29875014)
Int Orthop. 2013 Jan;37(1):99-104. (PMID: 23223970)
Clin Orthop Relat Res. 2015 May;473(5):1789-96. (PMID: 25352262)
Orthop Traumatol Surg Res. 2017 Nov;103(7):1131-1136. (PMID: 28645704)
Clin Orthop Relat Res. 2015 Sep;473(9):3003-13. (PMID: 25995179)
World J Surg Oncol. 2016 Mar 31;14:93. (PMID: 27030028)
J Orthop Sci. 2014 Nov;19(6):1004-11. (PMID: 25146001)
Rheumatol Ther. 2016 Dec;3(2):221-243. (PMID: 27761754)
Bone Joint J. 2014 Sep;96-B(9):1258-63. (PMID: 25183600)
J Pediatr Orthop. 1999 Jul-Aug;19(4):543-8. (PMID: 10413011)
J Surg Oncol. 2016 Jun;113(7):811-7. (PMID: 27126893)
J Pediatr Orthop. 2013 Apr-May;33(3):244-53. (PMID: 23482259)
Clin Orthop Relat Res. 1991 Mar;(264):156-68. (PMID: 1997230)
Medicine (Baltimore). 2018 Oct;97(40):e12605. (PMID: 30290632)
J Bone Joint Surg Am. 2005 Sep;87 Suppl 1(Pt 2):226-36. (PMID: 16140796)
Clin Orthop Relat Res. 2013 Mar;471(3):762-73. (PMID: 22948524)
Cancer. 2006 Mar 1;106(5):1154-61. (PMID: 16421923)
Clin Orthop Relat Res. 1999 Jan;(358):15-26. (PMID: 9973972)
Cancer Res. 1978 Feb;38(2):277-87. (PMID: 202383)
J Bone Oncol. 2019 Jan 25;16:100220. (PMID: 31044134)
Plast Reconstr Surg. 2005 Dec;116(7):1918-25. (PMID: 16327604)
Microsurgery. 2011 Mar;31(3):205-11. (PMID: 21360586)
J Bone Joint Surg Br. 2011 Aug;93(8):1111-7. (PMID: 21768638)
Radiology. 1991 Sep;180(3):813-6. (PMID: 1871299)
World J Surg Oncol. 2017 Jan 9;15(1):13. (PMID: 28069064)
Int Wound J. 2022 Nov;19(7):1616-1624. (PMID: 35122396)
J Bone Joint Surg Am. 1977 Mar;59(2):174-9. (PMID: 845200)
J Bone Joint Surg Am. 2004 May;86(5):948-55. (PMID: 15118037)
Plast Reconstr Surg. 2007 Mar;119(3):915-24; discussion 925-6. (PMID: 17312496)

2022JJ30441 the Hunan Provincial Natural Science Foundation of China; 202202023751；D202304077225 the Project of Hunan Provincial Health Commission; kq2202270; kq2208316 the Changsha Natural Science Foundation of China; 21B0383 the Scientific Research Fund of Hunan Provincial Education Department

Keywords: Endoprosthetic replacement; Epiphyseal preservation; Limb salvage; Osteosarcoma; Reconstruction

Date Created: 20240720 Date Completed: 20240720 Latest Revision: 20240725

20240726

PMC11264714

10.1186/s12891-024-07651-3

39033278