Abstract: Background: Currently 90-95% of sarcomas around the knee can be treated safely with wide resection and limb salvage surgery. Advancement of material science and design in endoprosthesis enables immediate rehabilitation, provides durable and functional limb. Primary goal is to restore and maintain stability and ambulation.
Aim of the study: To determine the functional outcome and complications of mega endoprosthesis.
Methods and Materials: Retrospective study conducted between 2008 to 2013 in an age group of 16 to 30 years with sarcomas around knee treated by mega endoprosthetic reconstruction. Total of 20 cases included in this study (Osteosarcoma- 12 cases, Giant cell tumour- 6 cases and Metastatic lesion – 2 cases) with tumour lesion at distal femur in 15 cases and 5 cases in proximal tibia. Follow up period was 48 months. Neo-adjuvant chemotherapy and post-op chemotherapy was given in selected cases. Functional outcome was scored by Musculoskeletal tumour society scoring (MSTS).
Results: The average MSTS functional score was 75% (Range - 60% to 100%). 4-year survival rate was 100% in our study. Range of movements at 4 years was 0-90°. Complications was observed in 5 cases. 2 cases had foot drop, one case had knee dislocation, and one case had flap necrosis and aseptic loosening in one case.
Discussion: Individual approach to every patient is essential in order to choose the most suitable surgical treatment.All our patients were below 30 years and 2/3rd were below 25 years of age, hence limb salvage is preferred over amputation.
Conclusion: Mega endoprosthetic reconstruction provides good functional outcome in patients with bone tumours around the knee. Endoprosthesis should be considered as treatment of choice for bone tumours around the knee.
