Publication:

Single center experience: midterm functional outcome of knee megaprosthesis after sarcoma resection

Background Endoprosthetic reconstruction following bone tumor resection is a well-known and popular method for preserving limbs. Endoprosthetic functional outcomes following reconstructions have been the topic of numerous studies the majority of which used subjective parameters like the Musculoskeletal tumor society (MSTS) score.

Methods A retrospective consecutive sampling strategy was used, and all eligible patients with knee tumours treated at Nariman hospital between 2020 and 2023 were identified from medical records and included. Due to the rarity of knee tumours and the limited annual case volume of approximately 8-10 cases, no formal a priori sample size calculation was performed. The final cohort consisted of all available eligible cases during the study period (n=40). Patients were followed for functional outcomes at 6 months, 1 year, and 2 years, with an average follow-up duration of 38 months (range: 30-71 months). Cases with failure, infection, local recurrence, death, or unavailable functional follow-up were reported separately in the attrition/outcome flow.

Results The functional outcome of knee tumor prosthesis was excellent with mean functional score for all patients were 68.71%. The mean functional score for distal femur patients was 71.94% while the mean functional score for proximal tibia cases was 63.85%. Younger patients with distal femur lesions showed better functional score, also patients with early management and early post-operative mobilization showed better results. The prosthesis survival was 90%.

Conclusions Limb salvage surgeries are complex surgeries which need multidisciplinary teamwork. Tumor endoprosthesis is the best option for limb reconstruction following tumor excision around the knee joint allowing early mobilization with low rate of infection and local recurrence.