Epiphyseal Preservation Surgery in Distal Femur Osteosarcoma

Conventional osteosarcoma is a primary intramedullar high grade malignant tumour in which the neoplastic cells produce osteoid Early diagnostic and accurate preoperative assessment of the extent of the tumor is crucial when a limb salvage procedure is being considered. More recent studies described the accuracy of magnetic resonance imaging for evaluation epiphyseal extension of osteosarcoma. With development of modern chemotherapy regimens, limb salvage procedure was developed. Most of surgical technique presently used to treat high grade metaphyseal osteosarcoma include resection of one or both epiphysis. If an osteoarticular allograft is used to reconstruct the joint, the epiphysis of the affected bone is lost, potentially creating anatomical mismatching or joint instability. Preservation of the epiphysis technique was potentially to maintain a nearly normal joint for several decades. The aim of this case is to report a case of a female, 12 years old, with osteosarcoma of distal femur to whom a Limb Salvage Surgery with Epiphseal Preservation technique was performed. After two years of follow up, no evidence of any metastasis was detected but the graft was fracture due to excessive load. Preservation of the epiphysis in distal femur osteosarcoma is an alternative surgery for tumor that does not extend to epiphysis. Extracorporeally irradiated autograft is a methode that can be used for reconstruction of distal femur osteosarcoma