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Extraarticular knee resection for sarcomas with preservation of the extensor mechanism: surgical technique and review of cases


Zwolak, P; Kühnel, S P; Fuchs, B (2011). Extraarticular knee resection for sarcomas with preservation of the extensor mechanism: surgical technique and review of cases. Clinical Orthopaedics and Related Research, 469(1):251-256.

Abstract

BACKGROUND: Sarcomas in or contaminating the knee are rare but extremely challenging to treat. Complete resection of the joint is necessary, and often the entire extensor mechanism is removed as well. Reconstruction of the knee is challenging, and the resulting function may be compromised. DESCRIPTION OF TECHNIQUE: We describe a surgical technique of extraarticular resection of the knee while preserving the extensor mechanism combined with prosthetic reconstruction. The medial and lateral retinaculum is prepared such that it allows extraarticular placement of K-wires that are driven through the patella and the proximal tibia, serving as in situ guides for the osteotomies.

PATIENTS AND METHODS: We retrospectively reviewed 11 patients with sarcomas contaminating the knee. The minimum followup was 14 months (mean, 38 months; range, 14-80 months).

RESULTS: At last followup patients had a mean flexion of 88° (range, 65°-120°). We observed no complications related to the extensor mechanism, and there was one local recurrence.

CONCLUSIONS: We believe extraarticular resection of the knee with preservation of the extensor mechanism is a reasonable treatment option for intraarticular sarcomas with functional scores comparable to those for patients having intraarticular resections.

LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Abstract

BACKGROUND: Sarcomas in or contaminating the knee are rare but extremely challenging to treat. Complete resection of the joint is necessary, and often the entire extensor mechanism is removed as well. Reconstruction of the knee is challenging, and the resulting function may be compromised. DESCRIPTION OF TECHNIQUE: We describe a surgical technique of extraarticular resection of the knee while preserving the extensor mechanism combined with prosthetic reconstruction. The medial and lateral retinaculum is prepared such that it allows extraarticular placement of K-wires that are driven through the patella and the proximal tibia, serving as in situ guides for the osteotomies.

PATIENTS AND METHODS: We retrospectively reviewed 11 patients with sarcomas contaminating the knee. The minimum followup was 14 months (mean, 38 months; range, 14-80 months).

RESULTS: At last followup patients had a mean flexion of 88° (range, 65°-120°). We observed no complications related to the extensor mechanism, and there was one local recurrence.

CONCLUSIONS: We believe extraarticular resection of the knee with preservation of the extensor mechanism is a reasonable treatment option for intraarticular sarcomas with functional scores comparable to those for patients having intraarticular resections.

LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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4 citations in Web of Science®
6 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:21 Jan 2011 21:07
Last Modified:05 Jan 2017 14:50
Publisher:Springer
ISSN:0009-921X
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s11999-010-1359-8
PubMed ID:20419485

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