Biologic reconstruction around the knee joint after tumor resectionDr. Amin Karimi , Orthopedic oncology surgeon SBMU

Distal femur and proximal tibia are the main localization of primary malignant bonetumor. New techniques in imaging, recent development in chemotherapy protocolsand surgery sharpening led to major improvement in management of malignantbone tumors around the knee, which allowed minimizing amputation ratio. Afterresection, total knee arthroplasty with tumoral prosthesis has become the goldstandard of reconstruction but a greater understanding of bone and allograft healinghas afforded opportunities to optimize biologic reconstructions after oncologicresections. Functional and oncologic results of this excision and reconstructive surgery arenow clearly established. However, this represents complex and risky interventions whichwill often lead to secondary surgical revision because of the young age of patients and theirfunctional demands. This can only stress the necessity of addressing patients to specialized,network-organized sarcoma teams.The orthopedic oncologist must have experience as well as a great deal of insight into theintricacies of each procedure and the wishes and demands of patients not only while theyare young but in into their adult life.In a resource challenged population the cost of prostheses can occasionally be a limitingfactor especially in cases of malignant tumors where the prognosis is guarded.Options for biologic reconstructions after oncologic resections around the knee included: