Abstract 109P
Background
We have observed that osteosarcoma often localizes and causes severe cortical bone destruction in the metaphysis, and it can extend intramedullary but does not invade the cortical bone structure in the diaphysis. In these cases, resecting a large bone segment or total bone replacement poses challenges and may yield less acceptable outcomes. To address this complexity, our approach involves using a combination of bone recycling with liquid nitrogen and megaprosthesis for reconstruction. We use nitrogen liquid to treat cancer cells in bone segments that are structurally intact, but where there is suspicion of malignant lesions in the root canal due to the spread of the primary tumor or skip lesions. This technique helps preserve the joint far from the tumor, avoiding radical surgery. Additionally, taking advantage of this graft increases the length of the root canal tunnel, facilitating the implantation of artificial materials.
Methods
This retrospective study included ten patients diagnosed with conventional osteosarcoma who underwent tumor resection and reconstruction using bone recycling with liquid nitrogen and megaprosthesis from 2022 to 2023.
Results
The average follow-up period was 14 months. The average duration for graft union was 5.75 months (range 4-7), and none of the patients required additional bone grafting. No local recurrence, metastasis, or wound infection was detected. Furthermore, there were no complications related to prosthetic or osteosynthesis autograft fractures, non-union, or aseptic loosening. The average MSTS score was 89% (range 86-92).
Conclusions
The surgical method combining artificial prosthesis and autografts treated with liquid nitrogen is an effective advancement in limb-sparing surgery for patients with large-sized bone cancer tumors that invade almost the total bone. It has shown significant benefits, including improved postoperative limb function, reduced treatment costs, and a lower complication rate and it could be a good alternative for total bone replacement or reconstruction with MGP or APC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
S.Q. Nguyen Tran Quang.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.