Evidence brief
Limb Salvage Surgery for Primary Bone Tumors
Similar survival rates for limb salvage vs amputation
Limb salvage preferred when wide margins achievable
Chemotherapy improved limb salvage rates
Reconstruction options evolved over time
Function generally better with limb salvage
Limb salvage with wide margins provides equivalent oncological outcomes to amputation with better function. Neoadjuvant chemotherapy response guides surgical planning.
Limb salvage indications: wide margin achievable, no major NV involvement, reconstruction feasible. Amputation: cannot achieve margins, NV involvement, patient preference, young child (limb length issues). Reconstruction: endoprosthesis, allograft, vascularized fibula. Discuss Huvos grading.
Simon MA et al. Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg Am. 1986;68(9):1331-1337.
Level III
Retrospective comparative study or case-control study