Proximal tibial resection and prosthetic reconstruction

Zachary Adler, Robert H. Quinn

Research output: Contribution to journalArticlepeer-review

Abstract

Proximal tibia resection with endoprosthetic reconstruction is a complex limb sparing procedure for tumors of the proximal tibia. Recent advances in implants and surgical techniques have made this option preferable to amputation for many patients. Long-term survival and recurrence rates are similar between limb salvage and limb ablation in the proximal tibia. Appropriate indications for limb salvage are imperative to mitigate disastrous outcomes such as loss of limb or life. A comprehensive perioperative evaluation should include a detailed history and physical, laboratory, and radiographic testing, along with a biopsy confirmed diagnosis before the definitive procedure. Once a patient has been appropriately evaluated, there are three steps critical to a successful procedure: proximal tibia resection, reconstruction of the proximal tibia and knee joint with a prosthetic component, and extensor mechanism reconstruction utilizing a gastrocnemius flap to improve implant coverage and enhance the patellar tendon repair. Proximal tibia resection with prosthetic reconstruction can be associated with significant complications; however, these can be minimized with appropriate preoperative planning and a meticulous technique.

Original languageEnglish (US)
Pages (from-to)88-98
Number of pages11
JournalTechniques in Orthopaedics
Volume22
Issue number2
DOIs
StatePublished - Jun 1 2007
Externally publishedYes

Keywords

  • Bone tumor
  • Complex total knee arthroplasty
  • Proximal tibial reconstruction
  • Proximal tibial replacement
  • Resection

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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