Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma
Introduction. Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction. Methods. In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor appa...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/6275861 |
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| author | Daniel A. Müller Giovanni Beltrami Guido Scoccianti Pierluigi Cuomo Francesca Totti Rodolfo Capanna |
| author_facet | Daniel A. Müller Giovanni Beltrami Guido Scoccianti Pierluigi Cuomo Francesca Totti Rodolfo Capanna |
| author_sort | Daniel A. Müller |
| collection | DOAJ |
| description | Introduction. Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction. Methods. In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft. Results. The mean follow-up was 6.7 years (range: 2–12.4 years). In two patients a local recurrence occurred, resulting in a 5-year local recurrence-free rate of 66.7% (95% CI: 19.5%–90.4%). Distant metastases were found in 4 patients resulting in a 5-year metastasis-free rate of 33.3% (95% CI: 4.6%–67.5%). Two patients underwent at least one revision surgery, including one patient in whom the allograft had to be removed. According to the ISOLS function score 24.7 points (range: 19–28 points) were achieved at the last follow-up. The mean active flexion of the knee joint was 82.5° (range: 25–120°) and a mean extension lag of 10° (range: 0–30°) was observed. Conclusions. The replacement of the extensor mechanism by an allograft is a reasonable option, allowing wide margins and restoration of active extension in most patients. Trial Registration. The presented study is listed on the ISRCTN registry with trial number ISRCTN63060594. |
| format | Article |
| id | doaj-art-75a840aa25bc4b77a6e6cbaa6b1457b1 |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-75a840aa25bc4b77a6e6cbaa6b1457b12025-02-03T01:11:33ZengWileyAdvances in Orthopedics2090-34642090-34722018-01-01201810.1155/2018/62758616275861Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue SarcomaDaniel A. Müller0Giovanni Beltrami1Guido Scoccianti2Pierluigi Cuomo3Francesca Totti4Rodolfo Capanna5Department of Orthopedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008 Zürich, SwitzerlandDepartment of Orthopedic Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Firenze, ItalyDepartment of Orthopedic Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Firenze, ItalyDepartment of Orthopedic Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Firenze, ItalyDepartment of Orthopedic Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Firenze, ItalyDepartment of Orthopedic Surgery, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56125 Pisa, ItalyIntroduction. Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction. Methods. In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft. Results. The mean follow-up was 6.7 years (range: 2–12.4 years). In two patients a local recurrence occurred, resulting in a 5-year local recurrence-free rate of 66.7% (95% CI: 19.5%–90.4%). Distant metastases were found in 4 patients resulting in a 5-year metastasis-free rate of 33.3% (95% CI: 4.6%–67.5%). Two patients underwent at least one revision surgery, including one patient in whom the allograft had to be removed. According to the ISOLS function score 24.7 points (range: 19–28 points) were achieved at the last follow-up. The mean active flexion of the knee joint was 82.5° (range: 25–120°) and a mean extension lag of 10° (range: 0–30°) was observed. Conclusions. The replacement of the extensor mechanism by an allograft is a reasonable option, allowing wide margins and restoration of active extension in most patients. Trial Registration. The presented study is listed on the ISRCTN registry with trial number ISRCTN63060594.http://dx.doi.org/10.1155/2018/6275861 |
| spellingShingle | Daniel A. Müller Giovanni Beltrami Guido Scoccianti Pierluigi Cuomo Francesca Totti Rodolfo Capanna Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma Advances in Orthopedics |
| title | Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma |
| title_full | Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma |
| title_fullStr | Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma |
| title_full_unstemmed | Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma |
| title_short | Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma |
| title_sort | allograft reconstruction of the extensor mechanism after resection of soft tissue sarcoma |
| url | http://dx.doi.org/10.1155/2018/6275861 |
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