Technical report demonstrates allograft-prosthesis composite reconstruction of the distal femur in children, indicating preserved tibial growth plates and functional limb salvage.
Key Points
To describe the surgical technique and rationale of resurfaced allograft-prosthesis composite reconstruction following distal femur bone tumor resection in pediatric patients.
Distal femoral tumor resection is planned using MRI with a 2-cm safety margin, verified intraoperatively by proximal marrow frozen-section analysis.
An unconstrained femoral knee component is cemented into a size-matched banked osteoarticular allograft, which is fixed to host bone using a long compression bridging plate.
Allograft ligaments and capsules are repaired to their host proximal tibial counterparts to restore joint stability, supplemented with temporary crossed pins if instability persists.
The reconstruction strategy spares the proximal tibial physis (growth plate) and retains substantial host bone stock for anticipated future revision surgeries.
The procedure provides functional joint reconstruction in young children under 9 years of age while lowering the risk of degenerative joint disease compared with isolated osteoarticular allografts.