The Journal of Bone and Joint Surgery, Vol 76, Issue 5 649-656, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study

BT Rougraff, MA Simon, JS Kneisl, DB Greenberg and HJ Mankin
Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medical Center, Illinois 60637.

The outcome of treatment of nonmetastatic high-grade osteosarcoma in the distal part of the femur was studied in 227 patients from twenty-six institutions. Eight of the seventy-three patients who had had a limb-salvage procedure and nine of the 115 patients who had had an above-the-knee amputation had a local recurrence, but there was no local recurrence in the thirty-nine patients who had had a disarticulation at the hip. There were no significant differences in the rate of survival or in the duration of the postoperative disease-free period between the three groups. One hundred and nine patients (48 per cent) were alive at an average of eleven years after the operation, and ninety patients (40 per cent) remained continuously disease-free. An additional operation on the limb was necessary more often for patients who had had a limb-salvage procedure than for those who had had an amputation. Function in seventy-eight living patients was assessed with the system of the Musculoskeletal Tumor Society for evaluation of function and by the functional assessment portion of the 1989 scoring system of the Knee Society; the scores were higher for the patients who had had a limb-salvage procedure than for the two groups of patients who had had an amputation. No difference was identified between the groups with regard to the patient's acceptance of the postoperative state, the ability to walk, or the amount of pain. The quality of life was evaluated for twenty-nine patients with a series of complex questionnaires.(ABSTRACT TRUNCATED AT 250 WORDS)
CiteULike    Connotea    Del.icio.us    Technorati    What's this?

This article has been cited by other articles:

				A. Gupta, J. Meswania, R. Pollock, S. R. Cannon, T. W. R. Briggs, S. Taylor, and G. Blunn Non-invasive distal femoral expandable endoprosthesis for limb-salvage surgery in paediatric tumours J Bone Joint Surg Br, May 1, 2006; 88-B(5): 649 - 654. [Abstract] [Full Text] [PDF]

				H. Futani, T. Minamizaki, Y. Nishimoto, S. Abe, H. Yabe, and T. Ueda Long-Term Follow-up After Limb Salvage in Skeletally Immature Children with a Primary Malignant Tumor of the Distal End of the Femur J. Bone Joint Surg. Am., March 1, 2006; 88(3): 595 - 603. [Abstract] [Full Text] [PDF]

				J. S. Weisstein, R. E. Goldsby, and R. J. O'Donnell Oncologic Approaches to Pediatric Limb Preservation J. Am. Acad. Ortho. Surg., December 1, 2005; 13(8): 544 - 554. [Abstract] [Full Text] [PDF]

				J. G. Wright and M. C. Gebhardt Multicenter Clinical Trials in Orthopaedics: Time for Musculoskeletal Specialty Societies to Take Action J. Bone Joint Surg. Am., January 1, 2005; 87(1): 214 - 217. [Full Text] [PDF]

				S. J. Withrow, J. M. Liptak, R. C. Straw, W. S. Dernell, V. J. Jameson, B. E. Powers, J. L. Johnson, J. H. Brekke, and E. B. Douple Biodegradable Cisplatin Polymer in Limb-Sparing Surgery for Canine Osteosarcoma Ann. Surg. Oncol., July 1, 2004; 11(7): 705 - 713. [Abstract] [Full Text] [PDF]

				K. C. Oeffinger and M. M. Hudson Long-term Complications Following Childhood and Adolescent Cancer: Foundations for Providing Risk-based Health Care for Survivors CA Cancer J Clin, July 1, 2004; 54(4): 208 - 236. [Abstract] [Full Text] [PDF]

				N. Marina, M. Gebhardt, L. Teot, and R. Gorlick Biology and Therapeutic Advances for Pediatric Osteosarcoma Oncologist, July 1, 2004; 9(4): 422 - 441. [Abstract] [Full Text] [PDF]

				M. Manfrini, D. Vanel, M. De Paolis, C. Malaguti, M. Innocenti, M. Ceruso, R. Capanna, and M. Mercuri Imaging of Vascularized Fibula Autograft Placed Inside a Massive Allograft in Reconstruction of Lower Limb Bone Tumors Am. J. Roentgenol., April 1, 2004; 182(4): 963 - 970. [Abstract] [Full Text] [PDF]

				M. Tanzer, R. Turcotte, E. Harvey, and J. D. Bobyn Extracortical Bone Bridging in Tumor Endoprostheses. Radiographic and Histologic Analysis J. Bone Joint Surg. Am., December 1, 2003; 85(12): 2365 - 2370. [Abstract] [Full Text] [PDF]

				S. A. Paluska Persistent Knee Pain in a Recreational Runner J Am Board Fam Med, September 1, 2003; 16(5): 435 - 442. [Full Text]

				M. R. DiCaprio and G. E. Friedlaender Malignant Bone Tumors: Limb Sparing Versus Amputation J. Am. Acad. Ortho. Surg., January 1, 2003; 11(1): 25 - 37. [Abstract] [Full Text] [PDF]

				R. Nagarajan, J. P. Neglia, D. R. Clohisy, and L. L. Robison Limb Salvage and Amputation in Survivors of Pediatric Lower-Extremity Bone Tumors: What Are the Long-Term Implications? J. Clin. Oncol., November 15, 2002; 20(22): 4493 - 4501. [Abstract] [Full Text] [PDF]

				C. P. Gibbs Jr., K. Weber, and M. T. Scarborough Malignant Bone Tumors J. Bone Joint Surg. Am., November 1, 2001; 83(11): 1728 - 1745. [Full Text] [PDF]

				R. M. Henshaw, D. A. Priebat, D. J. Perry, B. M. Shmookler, and M. M. Malawer Survival After Induction Chemotherapy and Surgical Resection for High-Grade Soft Tissue Sarcoma. Is Radiation Necessary? Ann. Surg. Oncol., July 1, 2001; 8(6): 484 - 495. [Abstract] [Full Text] [PDF]

				G. Bacci, S. Ferrari, F. Bertoni, P. Ruggieri, P. Picci, A. Longhi, R. Casadei, N. Fabbri, C. Forni, M. Versari, et al. Long-Term Outcome for Patients With Nonmetastatic Osteosarcoma of the Extremity Treated at the Istituto Ortopedico Rizzoli According to the Istituto Ortopedico Rizzoli/Osteosarcoma-2 Protocol: An Updated Report J. Clin. Oncol., December 15, 2000; 18(24): 4016 - 4027. [Abstract] [Full Text] [PDF]

				A. HILLMANN, C. HOFFMANN, G. GOSHEGER, H. KRAKAU, and W. WINKELMANN Malignant Tumor of the Distal Part of the Femur or the Proximal Part of the Tibia: Endoprosthetic Replacement or Rotationplasty. Functional Outcome and Quality-of-Life Measurements J. Bone Joint Surg. Am., April 1, 1999; 81(4): 462 - 8. [Abstract] [Full Text]

				M. M. Hudson, V. L. Tyc, L. K. Cremer, Xiaolong Luo, Hao Li, B. N. Rao, W. H. Meyer, D. B. Crom, and C. B. Pratt Patient Satisfaction After Limb-Sparing Surgery and Amputation for Pediatric Malignant Bone Tumors Journal of Pediatric Oncology Nursing, January 1, 1998; 15(2): 60 - 69. [Abstract] [PDF]

				R. B. Mosher and B. J. McCarthy Late Effects in Survivors of Bone Tumors Late Effects in Survivors of Bone Tumors Journal of Pediatric Oncology Nursing, January 1, 1998; 15(2): 72 - 84. [Abstract] [PDF]