Functional Results of Use of Mesh in Orthopaedic Oncology Surgery (Long Term Follow Up)

Abstract

Background: Diagnosis of a malignant bone tumour has been confusing to a general orthopaedic surgeon. Advancement in ra¬dio and chemotherapy fields and better diagnostic modalities helped a lot in the improvement of results of limb salvage surgery. In limb salvage surgeries after tumour resection, replacement with mega-prosthesis is one of the standard methods. To improve functional outcomes, we have used mesh in our study. Objectives: To evaluate the results of the use of mesh in limb salvage surgeries done for malignant bone tumours by compar¬ing the range of movements with a group of patients in which mesh was not used. The objective is to assess the clinical and functional outcomes of the patients. Methods: A retrospective study of 19 patients was carried out. We included patients with a minimum follow up of 6 months. The study includes all common regions of the body affected by the malignant bone tumour (lower end femur, upper-end tibia, upper-end femur and upper-end humerus) operated by limb salvage surgery and mega-prosthesis replacement. Two study groups, one without mesh and one with the use of mesh were compared. We have used mesh in primary reconstruction surgery. Results: Results were evaluated by the Musculo Skeletal Tumour Society (MSTS) scoring system showed a good range of movements in terms of Shoulder abduction (for Proximal humerus replacement) [Figure 1,2&3] and knee extension. Conclusion: Use of mesh induces fibrosis and provides anchorage to soft tissues and muscles in limb salvage surgery. Thus achieves a good range of active movements and can lessen the time for immobilization. Thus it helps psychosocial rehabilitation of the family and society5,6.