Review Article - Limb salvage for malignant primary bone tumours: current status with a review of the literature

Though primary malignant bone tumours form only about 1% of all cancers, their aggressive natural history makes disease control very difficult. Effective chemotherapy has improved survival and advances in imaging, engineering and surgical techniques have made limb salvage feasible and the world has moved from amputation to limb salvage in the majority of cases with non-metastatic disease at presentation. Indigenously developed technology and chemotherapy protocols have allowed our own results to be comparable to those reported in the Western literature. Newer biomaterials and fabrication methods have allowed us to develop indigenously a high-quality yet affordable customized megaprosthesis which forms the backbone of limb salvage surgery. This paper broadly reviews the literature and presents our own experience with the current limb salvage methods as carried out at the Tata Memorial Hospital.

Keywords
Limb salvage, Endoprosthesis, Megaprosthesis, Rotationplasty, Osteosarcoma, Ewing's sarcoma, Biopsy, Neoadjuvant chemotherapy