COMPARISON OF LIMB SALVAGE WITH MEGA PROSTHESIS VERSUS AUTO GRAFT RECONSTRUCTION AFTER CRYOTHERAPY IN LIMB SARCOMA PATIENTS

OB ZIA; MK SHAFI; T RAZA; MT KHALIL; U ALI; SAR ABIDI; N AKHTAR

doi:10.54112/bcsrj.v2023i1.640

Authors

OB ZIA Department of Orthopedic Surgery, Liaquat College of Medicine and Dentistry, Darul Sehat Hospital, Karachi, Pakistan
MK SHAFI Department of Orthopedic Surgery, Nishtar Medical University, Multan, Pakistan
T RAZA Department of Orthopedic, KMU Institute of Medical Sciences, Kohat, Pakistan
MT KHALIL Department of Orthopedic Surgery, Fatima General Hospital, DG Khan, Pakistan
U ALI Department of Trauma and Orthopedic Surgery, Mayo Hospital, Lahore, Pakistan
SAR ABIDI Department of Orthopedic Surgery, Jinnah Medical &Dental College, Karachi, Pakistan
N AKHTAR Department of Oncology, IRNUM Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.640

Keywords:

Osteosarcoma, Limb salvage, Mega prosthesis, Auto graft reconstruction, Cryotherapy

Abstract

Osteosarcoma is the most common primary malignant bone tumor, with children and adolescents being the most at-risk population. It accounts for 2% of all childhood tumors. The main goal of this study was to compare the use of limb salvage with mega prosthesis versus auto graft reconstruction after cryotherapy in patients with limb sarcoma. This retrospective study was conducted at Liaquat College of Medicine and Dentistry Darul Sehat Hospital Karachi from June 2023 to August 2023. The data was collected with the permission of the hospital's ethical committee. A standard uniform management protocol was adopted for each case. All patients were skeletally immature, with the predicted overall growth of less than 3 cm calculated using the Multiplier method. The data was collected from 45 patients with a mean age of 13.8±4.6 years. The predominant type of tumor was Osteosarcoma (77.14%) followed by Ewing Sarcoma and Chondrosarcoma. Five patients required a more extended hospital stay after mega prosthesis as compared to the other group. It is concluded that patients with limb sarcomas treated with Mega prosthesis had better functional outcomes than those treated with autograft reconstruction after cryotherapy.

Downloads

Download data is not yet available.

References

Araki, Y., Yamamoto, N., Hayashi, K., Takeuchi, A., Miwa, S., Igarashi, K., Higuchi, T., Abe, K., Taniguchi, Y., and Yonezawa, H. (2021). Clinical outcomes of frozen autograft reconstruction for the treatment of primary bone sarcoma in adolescents and young adults. Scientific Reports 11, 17291.

Bickels, J., Dadia, S., and Lidar, Z. (2009). Surgical management of metastatic bone disease. JBJS 91, 1503-1516.

Bilal, M., Jilani, S. R.-U.-A., Rafi, I., Shakeel, O., and Jabeen, W. (2021). Early outcomes of limb salvage surgery with mega-prosthesis: A single center experience. Journal of Acute Disease 10, 208-215.

Brookes, M. J., Chan, C. D., Baljer, B., Wimalagunaratna, S., Crowley, T. P., Ragbir, M., Irwin, A., Gamie, Z., Beckingsale, T., and Ghosh, K. M. (2021). Surgical advances in osteosarcoma. Cancers 13, 388.

Cartiaux, O., Banse, X., Paul, L., Francq, B. G., Aubin, C.-É., and Docquier, P.-L. (2013). Computer-assisted planning and navigation improves cutting accuracy during simulated bone tumor surgery of the pelvis. Computer Aided Surgery 18, 19-26.

Ehara, S., Nishida, J., Shiraishi, H., and Tamakawa, Y. (2000). Pasteurized intercalary autogenous bone graft: radiographic and scintigraphic features. Skeletal radiology 29, 335-339.

Enneking, W., and Shirley, P. (1977). Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. JBJS 59, 223-236.

Garg, S. K., Aggarwal, P., Virk, J., Punia, R., Dimri, K., and Jindal, R. (2020). Limb salvage using liquid nitrogen-treated tumour-bearing autograft: a single institutional experience of 10 patients. Indian Journal of Orthopaedics 54, 200-207.

Gede, E. W. I., Ida Ayu, A. A., Setiawan I GN, Y., Aryana IGN, W., I Ketut, S., I Ketut, S. K., and Putu, A. (2017). Outcome of bone recycling using liquid nitrogen as bone reconstruction procedure in malignant and recurrent benign aggressive bone tumour of distal tibia: A report of four cases. Journal of Orthopaedic Surgery 25, 2309499017713940.

Higuchi, T., Yamamoto, N., Nishida, H., Hayashi, K., Takeuchi, A., Kimura, H., Miwa, S., Inatani, H., Shimozaki, S., and Kato, T. (2017). Knee joint preservation surgery in osteosarcoma using tumour-bearing bone treated with liquid nitrogen. International Orthopaedics 41, 2189-2197.

Kinkel, S., Lehner, B., Kleinhans, J., Jakubowitz, E., Ewerbeck, V., and Heisel, C. (2010). Medium to long‐term results after reconstruction of bone defects at the knee with tumor endoprostheses. Journal of surgical oncology 101, 166-169.

Krettek, C., Geerling, J., Bastian, L., Citak, M., Rücker, F., Kendoff, D., and Hüfner, T. (2004). Computer aided tumor resection in the pelvis. Injury 35, S-A79.

Lauritzen, C., Alberius, P., Santanelli, F., Vällfors, B., Lilja, J., and Stephensen, H. (1991). Repositioning of carniofacial tumorous bone after autoclaving. Scandinavian journal of plastic and reconstructive surgery and hand surgery 25, 161-165.

Manabe, J., Ahmed, A. R., Kawaguchi, N., Matsumoto, S., and Kuroda, H. (2004). Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma. Clinical Orthopaedics and Related Research (1976-2007) 419, 258-266.

Mirabello, L., Troisi, R. J., and Savage, S. A. (2009). International osteosarcoma incidence patterns in children and adolescents, middle ages and elderly persons. International journal of cancer 125, 229-234.

Ni, J., Ling, H., Zhang, S., Wang, Z., Peng, Z., Benyshek, C., Zan, R., Miri, A., Li, Z., and Zhang, X. (2019). Three-dimensional printing of metals for biomedical applications. Materials Today Bio 3, 100024.

Ozaki, T., Flege, S., Kevric, M., Lindner, N., Maas, R., Delling, G. n., Schwarz, R., Von Hochstetter, A. R., Salzer-Kuntschik, M., and Berdel, W. E. (2003). Osteosarcoma of the pelvis: experience of the Cooperative Osteosarcoma Study Group. Journal of clinical oncology 21, 334-341.

Puri, A. (2015). Limb salvage: When, where, and how? Indian journal of orthopaedics 49, 46.

Sadykova, L. R., Ntekim, A. I., Muyangwa-Semenova, M., Rutland, C. S., Jeyapalan, J. N., Blatt, N., and Rizvanov, A. A. (2020). Epidemiology and risk factors of osteosarcoma. Cancer investigation 38, 259-269.

Sharil, A., Nawaz, A., Azman, M. N., Zulmi, W., and Faisham, W. (2013). Early functional outcome of resection and endoprosthesis replacement for primary tumor around the knee. Malaysian orthopaedic journal 7, 30.

URIST, M. R., and DAWSON, E. (1981). Intertransverse process fusion with the aid of chemosterilized autolyzed antigen-extracted allogeneic (AAA) bone. Clinical Orthopaedics and Related Research® 154, 97-113.

Whelan, J., Bielack, S., Marina, N., Smeland, S., Jovic, G., Hook, J., Krailo, M., Anninga, J., Butterfass-Bahloul, T., and Böhling, T. (2015). EURAMOS-1, an international randomised study for osteosarcoma: results from pre-randomisation treatment. Annals of oncology 26, 407-414.