Nerve Palsy following Reconstruction around the Knee in Musculoskeletal Oncology – A Single Institutional Experience of 30 Cases in a Quarternary Cancer Centre from India

Introduction The 21st century has shifted the paradigm in surgical management of most limb malignancies, making limb salvage not just an option, but the norm, as a result of effective adjuvant therapy, superior imaging, improved surgical technique and advanced biomaterials and mechanics [1]. Nowadays, more than 80% of the patients are treated with limb salvage surgery without critically compromising oncological principles [2]. The knee region, consisting of the proximal tibia, distal femur and the surrounding soft tissue, is the commonest site of predilection for primary bone tumors. In the knee, the distal femur is the most common site, followed in descending order by proximal tibia [3-7]. In limb-salvage surgery for bone tumor, there are 3 main ways to reconstruct the bone defect after tumor resection: auto graft or allograft, inactivation and re-implantation, and artificial prosthesis replacement [8]. Allografts and endo prostheses are the most commonly used replacements for the osteo articular defect resulting from en bloc resection of primary malignant bone tumors from the distal femur or proximal tibia [9-11].