Distally Based Sartorius Flap for Knee Joint Soft Tissue Defect Reconstruction Post-Extensive Oncological Resection of Soft Tissue Sarcoma

Abstract Reconstruction of soft tissue defects around the knee joint presents significant challenges, particularly in oncological resections involving prior surgeries, vascular compromise, and extensive soft tissue defects. We present the case of a 60-year-old female with recurrent pleomorphic liposarcoma of the left thigh, previously treated with wide local excision. She underwent compartmental resection of a 16 × 8 × 4 cm tumor involving medial thigh structures, including excision of segments of the femoral artery and vein, exposing the vasti muscles and patella. Vascular reconstruction was performed; however, due to compromised vasculature and limited donor sites, free flap reconstruction was deemed unfeasible. A distally based sartorius muscle flap was used to cover the exposed patella, supplemented with a split-thickness skin graft. Intraoperative indocyanine green angiography confirmed adequate flap perfusion. The postoperative course was uneventful, and the patient is currently undergoing adjuvant radiotherapy. This case highlights the reliability of the distally based sartorius flap in scenarios with limited reconstructive options.