Authors
Brayan R Pedroza, Gabriel De Jesús Narvaez Carrasquilla, Alejandro Uribe Marín, Diana Katherine Conde Patiño, Camilo Andrés Galvan Baldovino
Published in
Orthopedic reviews. Volume 18. Pages 163734. Epub Jul 01, 2026.
Abstract
Malignant tumors around the knee pose a complex reconstructive challenge, particularly in the setting of an unreconstructable extensor mechanism. Although limb-salvage surgery with megaprosthetic reconstruction is the standard approach, its success is contingent upon extensor mechanism preservation. When this is not achievable, knee arthrodesis with modular endoprosthetic systems remains a robust salvage strategy.
A 17-year-old male presented with a one-year history of progressive left knee swelling, pain, and functional impairment. Imaging demonstrated extensive involvement of the soft tissues, distal femur, and proximal tibia, with articular extension and close association with the patellar tendon. Biopsy confirmed Ewing sarcoma. The patient underwent neoadjuvant chemotherapy with vincristine, doxorubicin, and cyclophosphamide. This was followed by wide oncologic resection, including the distal femur, proximal tibia, and extensor mechanism, and reconstruction with a knee arthrodesis prosthesis. Final histopathology confirmed negative margins and 30% tumor necrosis. At 6-month follow-up, the patient remained disease-free with satisfactory functional recovery.
Endoprosthetic knee arthrodesis provides a durable and oncologically sound limb-salvage option in cases where the extensor mechanism cannot be reconstructed. Optimal outcomes depend on appropriate patient selection and rigorous oncologic management.
PMID:
42405302
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.
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