Limb Salvage Surgery

Limb-salvage surgery is a surgical option for malignant tumor in a long bone of leg or arm.
Limb-salvage surgery helps preserve the limb by removing the part of the bone involved with the tumor and some of the tissues that surround it. The bone is replaced with an implant, which can be either a bone graft or a metal prosthesis.
Limb-salvage surgery is part of the treatment for osteosarcoma or Ewing sarcoma. The goal of limb-salvage surgery is to preserve as much of the limb as possible. However, the arm or leg will never be as strong as it was before surgery. Children who have this surgery will not be able to participate in high-impact sports using the affected limb.

What types of implants can be used to replace bone during limb-salvage surgery?

There are three main categories of implants used as part of limb-salvage surgery:

• Endoprosthesis, a metal implant that replaces the bone. A traditional “adult” endoprosthesis can't be lengthened and is most often used on full-grown or almost fully grown teens and young adults. If a patient has a small amount of growth remaining, the surgeon may implant a slightly longer endoprosthesis so the two limbs will be close in length when the other has finished growing.
• Expandable prosthesis, a relatively new option for children at a middle stage of growth. As the child grows, they will have periodic limb lengthenings. A strong magnet is used to extend a tube inside another tube in the metal implant. The prosthesis is expanded in small increments so that both limbs remain about the same length.
• Allograft bone replacement, bone from an organ donor replaces the bone around the tumor. An allograft implant does not grow. The surgeon may therefore implant a slightly longer length of bone to compensate for future growth of the other limb.