Orthopedic surgery options for the treatment of primary osteosarcoma.

BACKGROUND Osteosarcoma is the most common malignant primary neoplasm of bone. Orthopedic procedures are essential components in the multidisciplinary treatment of osteosarcoma. Limb-salvaging procedures offer adequate disease control comparable to the results obtained by amputations. This review discusses the advantages and disadvantages of the various types of amputations and the limb-salvaging techniques for the treatment of osteosarcoma. METHODS The authors analyzed the characteristics of limb-salvaging procedures and amputations for osteosarcoma. Qualitative and quantitative studies published in the English language that are listed in the National Library of Medicine were used as the basis for this review. In addition, a review of an expandable prosthesis is included. RESULTS Limb-salvaging techniques have acceptable rates of disease control. However, amputation remains a valid procedure in selected cases of osteosarcoma in most parts of the world. Orthopedic oncology surgeons have various materials, procedures, and techniques available to achieve disease control and improve function in patients with osteosarcoma. CONCLUSIONS The surgical management of patients with osteosarcoma is challenging. No difference in survival has been shown between amputations and adequately performed limb-salvaging procedures. Optimal tumor resection and a functional residual limb with increased patient survival are the goals of modern orthopedic oncology.