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Extraarticular Knee Resection for Sarcomas with Preservation of the Extensor Mechanism: Surgical Technique and Review of Cases

Zwolak, Pawel ; Kühnel, Stefanie ; Fuchs, Bruno

In: Clinical Orthopaedics and Related Research®, 2011, vol. 469, no. 1, p. 251-256

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    Title
    • Extraarticular Knee Resection for Sarcomas with Preservation of the Extensor Mechanism: Surgical Technique and Review of Cases
    Author
    • Zwolak, Pawel. Department of Orthopaedics, Division of Orthopaedic Oncology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland
    • Kühnel, Stefanie. Department of Orthopaedics, Division of Orthopaedic Oncology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland
    • Fuchs, Bruno. Department of Orthopaedics, Division of Orthopaedic Oncology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Clinical Orthopaedics and Related Research®, 2011, vol. 469, no. 1, p. 251-256. Springer-Verlag
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:320890
    Summary
    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 14months (mean, 38months; range, 14-80months). 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