This text is a general description of a distal femoral resection. Focus is on anatomical structures and muscle resection. Each femoral resection is different based on tumor biology, extension and tissue contamination. Good pre-operative imaging is mandatory as well as pre-operative planning.
Based on tumor biology (biopsy first!) tumor resection is determined. Which structure can be saved? Nerves (sciatica, femoral, saphenous) or vessels involvement should be anticipated and discussed with the patient first. Important muscle resection can create functional deficit, particularly knee extension weakness. Expected function and major risk like infection or neurovascular deficit should be discussed pre-operatively with the patient; particularly saphenous nerve possible sacrifice and associated medial leg anesthesia.
For a distal femoral resection many anatomical structures should be considered. Normal anatomy must be known to avoid nerve or vessel damage. Remaining structures should be vascularised and innervated. All above structures must be known as well as their anatomic course.