Abstract
In patients who undergo reconstruction after resection of malignant tumors around the knee joint, proper flap selection and choice of recipient vessels are important considerations. We report our experience with reconstruction using free or pedicle flaps for malignant tumors around the knee joint. This report details the results from 11 patients. There were four cases of malignant fibrous histiocytoma, four cases of osteosarcoma of the proximal tibia, and one case each of liposarcoma, synovial sarcoma and malignant myxofibroma. Reconstruction was performed at the same time as tumor resection in six cases, and reconstruction was performed after operation due to complications with wound healing in five cases. Though all flaps survived, there were two cases of surgical site infection that required reoperation. In patients with large soft tissue defects and when prosthetic material is considered in the reconstruction, we believe that latissimus dorsi musculocutaneous flaps are a suitable method of reconstruction. On the other hand, in patients with small defects, we typically select a proximally-based sural artery flap. Proper selection of recipient vessels is crucial, as is selection of flaps. Our first choice is the descending genicular vessels because of the presence of genicular vessels of adequate size that are generally reliable and constant.
