Page 185 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Patients and Methods
We present a retrospective case series of all patients with a primary malignant or aggressive benign bone or soft tissue tumor in whom a MUTARS distal femoral or proximal tibial replacement was performed for primary reconstruction or for revision of a failed previous reconstruction. Institutional databases were searched to identify patients who had MUTARS reconstruction between 1995 and 2010 with a minimum follow-up of ve years. During the early period under study, we performed a limited number of osteoarticular allograft reconstructions, mainly in young patients. In case it was possible to save adjacent joints, we preferred to perform an intercalary resection and reconstructed the defect with an allograft9, 19. Generally speaking, endoprosthetic reconstruction was the preferred method of reconstruction when resection of the knee was deemed inevitable in adolescents and adults. No other endoprosthetic systems have been used in our centers. We performed a total of 114 MUTARS reconstructions about the knee during the period in question in 105 patients. Four patients (four of 105 [4%]) were lost to follow-up, leaving 110 reconstructions in 101 patients for review; of these, 64 (64 of 101 [63%]) were alive at nal review. The reverse Kaplan-Meier method was used to calculate the median follow-up, which was equal to 8.9 years (95% con dence interval [CI], 8.0 – 9.7) (table 1).
Table 1. Study data Variable
SexMale Female
Diagnosis
Osteosarcoma
Leiomyosarcoma of bone Chondrosarcoma
Giant cell tumor of bone
Pleomorphic undi erentiated sarcoma Ewing sarcoma
Low-grade osteosarcoma
Sarcoma not otherwise speci ed Synovial sarcoma
Di use-type giant cell tumor
Number Percent of relevant group
55 55 46 45
56 55 10 10 9 9 8 8 7 7 5 5 2 2 2 2 1 1 1 1
9
MUTARS knee replacement
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