Most of patients with lower extremity sarcoma will require reconstructive procedures in order to restore structural integrity. However, some locations and circumstances do not always require reconstruction to deal with the surgical defect. As an example, pelvic tumors may not require postresection reconstruction following an internal hemipelvectomy. Expendable bones that do not require replacement include the ulna, patella, fibula, scapula, and ribs. Resection techniques for tumors in these locations are well described, and the resultant functional disability without bony reconstruction is frequently minimal. For patients who do require reconstruction, available methods include metal endoprostheses/hardware, allografts, arthrodesis, vascularized …show more content…
A brief description of some of these techniques follows.
1. Allografts and endoprostheses
Allografts and metal endoprostheses are common means of reconstructing bone defects that result from sarcoma surgery. Other methods listed below may be preferred to fill the osseous defect depending on the clinical situation and the availability of the product.
• Allografts
While autologous bone grafting is of limited use in patients undergoing resection of bone tumors because of the large size of the defect, allografts have been successfully used for many years. Allografts provide the potential for long-lasting reconstruction of large bony defects by providing a structural lattice for the ingrowth of the patient's own bone elements [95-101]. The major advantages of allografts over endoprosthetic reconstruction are restoration of bone stock, sparing of the uninvolved portion of adjacent joints, and providing a site of attachment for host soft tissues. There are some disadvantages to allografts. Compared with metal endoprostheses, allografts must be fixed to the host bone and allowed to heal. Thus, they must be protected from weight bearing for prolonged periods. Early complication rates (15 to 20 percent) are higher than those seen in patients undergoing placement of metal