A Comparative Study on the Clinical and Functional Outcome of Limb Salvage Surgery and Amputation in Tibial Osteosarcoma

The aim of this study was to analyze the survival, recurrence, complications as well as the quality of life (QOL) in tibial osteosarcoma (OSA) patients managed by limb salvage surgery (LSS), either by a prosthesis, resection or graft or by amputation.

106 tibial osteosarcoma patients were enrolled where 39 had custom-designed endoprosthetic arthroplasty (LSS1), 36 underwent resection and bone graft (LSS2) while only 31 underwent amputation. A Comparison was done based on post-operative survival rates, postoperative recurrence, and complications. The impact of the patient’s QOL was also evaluated.

The results of our study showed that the incidence of tibial OSA was higher in <20 years (63%) where M: F was 1.52:1. The mean survival of patients with LSS1 was 2.51 years(Confidence interval-95%;0.3-7.58 years), LSS2 was 4.15 (CI-95%;0.35-8.65 years) and amputation was found to be 4.79 years(CI-95%;0.6-8.39 years) with overall mean survival time was 3.72 years (CI-95%;p=0.0002). The Complication rate was lower in LSS1 and LSS2 (46.67%, CI-95%; p = 0.048). The mean MSTS score was 68.8% (range, 43.56%-89.16%) with significantly lower results than in amputations (p = 0.007). The QOL assessment done by SF-36 revealed a better state of LSS1 and LSS2 patients. The sarcoma led to emotional and functional disturbances in amputated patients (CI-95%, p =0.004). The complication-free patients were found to be higher in LSS groups (53.33%) (CI-95%, p =0.048).

Limb Salvage Surgery for tibial osteosarcoma is superior to amputation due to its better functional outcome and fewer complications.