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京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18199号 / 人健博第16号 / 新制||人健||2(附属図書館) / 31057 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 黒木 裕士, 教授 足立 壯一, 教授 三谷 章 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Introduction: Below knee amputation is the safest treatment for aggressive benign and malignant bone tumours of the distal tibia yielding good oncological and functional results. However, in selected patients where limb salvage is feasible and amputation unacceptable to the patient, limb salvage using a distal tibial replacement (DTR) can be considered. This study aims to present the oncological and functional results of the use of this treatment method in our unit. Patients & Methods: A retrospective folder review was performed for all 10 patients who received a modular distal tibial replacement between 01/01/2005 and 31/01/2019 for a primary bone tumour either benign aggressive or malignant. Six were female and the mean age was 31 (1275) years. There were five patients with giant cell tumour of bone, four with osteosarcoma and one with a low-grade chondrosarcoma. The patients with osteosarcoma had neo-adjuvant chemotherapy before surgery. Function was assessed by the Musculoskeletal Tumor Society (MSTS) score. Results: There were six females and four males, with a mean age of 31 (12-75) years. Two patients had local recurrence treated with a BKA and one other patient died of metastases three years postoperatively. At a mean follow-up of three years, the remaining eight patients had a mean MSTS score of 83% (67–93%). There were no radiological signs of loosening, and no revision surgeries. Conclusion: Endoprosthetic replacement of the distal tibia for primary bone tumours can be a safe treatment option in very selected cases.