Standardized surgical plan for fibular proximal malignant tumors needed to improve outcomes

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The reconstruction of the biceps femoris tendon and lateral collateral ligament insertion point can be a useful technique for restoring knee function and stability after surgery in patients with fibular proximal malignant tumors, according to a study.

This retrospective analysis of medical records included 10 cases of osteosarcoma, 3 cases of chondrosarcoma, 2 cases of invasive giant cell osteosarcoma tumor, 1 case of epithelioid sarcoma, 1 case of leiomyosarcoma, 1 case of fibrosarcoma, and 1 case of lymphoma. Based on the Enneking installment, the study found that IB stage was present in 2 cases, IIA in 2 cases, and IIB in 15 cases.

The surgical procedures performed on the patients varied, with 3 patients undergoing Malawer I resection and 16 patients undergoing Malawer II resection. The follow-up period ranged from 11 to 174 months, with an average of 76.58 months.

Local recurrence occurred in 3 patients, and distant metastasis was found in 7 patients. Overall, 4 patients died and 15 were alive at the end of the study period.

After the resection of proximal fibula primary and invasive tumors, the researchers reconstructed the biceps femoris tendon and lateral collateral ligament insertion point. The study found that this technique can effectively reconstruct stability and restore knee function, with 18 patients having good knee stability after surgery, as assessed by the Musculoskeletal Tumor Society scale, which ranged between 23 and 29 points, with an average of 27.26 points. The Lysholm Knee Score was 65-84 points, with an average of 83 points.

The authors concluded that a standardized surgical plan for fibular proximal malignant tumors is needed to achieve better outcomes for patients.

Pu F, Yu Y, Zhang Z, et al. Clinical effect of surgical resection on primary malignant and invasive bone tumours of the proximal fibula. Mol Clin Oncol. 2023;18(4):27. doi: 10.3892/mco.2023.2623. PMID: 36908975; PMCID: PMC9996172.