Function and complications after ablative and limb-salvage therapy in lower extremity sarcoma of bone

Background and Objectives: The functional results and the complications aft er several limb-saving and ablative treatments because of lower extremity b one sarcoma were evaluated. Methods: Seventy-seven surviving patients were evaluated according to the M STS (American Musculoskeletal Tumor Society) functional rating system. Fift y-two patients had limb-saving and 25 had ablative therapy. Median follow-u p was 97 months in the limb-saving group and 112 months in the ablative gro up. Results: Functional results in the limb-saving group were significantly bet ter than in the ablative group (P = 0.0001). Functional results in patients with tumors about the knee joint were significantly better (P = 0.0064) af ter limb-saving surgery (i.e., endoprosthesis, knee arthrodesis, or rotatio nplasty) compared to functional results after ablative surgery (i.e., hip o r knee disarticulation or above-the-knee amputation). Complications were 3 times more common after limb-salvage procedures and 4 times more common aft er endoprosthetic reconstructions compared to after ablative procedures. Co mplications after limb-saving therapy were fewest in tumors about the knee joint. In 3/28 patients, the endoprosthetic reconstruction had to be conver ted to an amputation. Conclusions: Functional results were significantly better after limb-saving compared to after ablative therapy. Complications, however, were more comm on after limb-saving therapy. (C) 2000 Wiley-Liss, Inc.