Limb preservation for osteosarcoma of femoral condylar: a clinical case of total knee replacement with microsurgical anterolateral thigh flap transfe

Background: Osteosarcoma is a high malignancy, early metastasis, and often leading to disability or limb amputation. Today, advances in science, technics, and materials, especially in joint replacement and reconstructive surgery with free flap transfer, open up hope for cancer patients in general, and bone cancer in particular about the preservation of limbs.

Case report: A 23-year-old woman with sarcoma of the right distal femur was undergone tumor resection and cement replacement one year ago. This time the patient was admitted to the hospital for a painful swollen right knee. She was diagnosed with recurrent femoral osteosarcoma. Additional wide resection of the tumor along with total knee replacement and pedicled medial gastrocnemius muscle flap for covering soft tissue defect was done. Two weeks after this operation, the muscle flap was necrosis, we decided to use an anterolateral thigh flap to cover soft tissue. Follow up 3 months after surgery showed good knee movement function: 90 degrees flexion, completely normally walking and painless.

Conclusion: In the surgical treatment of bone cancer, total joint replacement surgery combined with reconstructive technics is helpful to preserve the limb of patients. If complex cases where local flaps do not enough for covering, the Anterolateral Thigh (ALT) flap is a good choice to combine with a total joint replacement for preserving patients’ extremities