Abstract
It is difficult to reconstruct the extensor mechanism of the knee joint following extensive resection for malignant soft tissue sarcoma generated in the anterior surface of the knee joint. We introduced a surgical technique for this condition using recycled tissue including bone and tendon, and free myocutaneous flap of latissimus dorsi. Three patients surgically underwent wide resection for malignant soft tissue sarcoma in the anterior knee. Then, the resected tissue was devitalized for tumor cells using irradiation or pasteurization. This recycled tissue included the inferior patella, patellar ligament, and anterior proximal tibia with tuberosity. The recycled tissues were fixed on both sides and covered by the free latissimus dorsi myocutaneous flap. All patients had good function with neither recurrence of sarcoma nor complications at an average of 3.5 years after the surgery. Moreover, histological findings demonstrated remodeling of recycled tendon with longitudinal arrangement of tendon cells, which was resected in the debulking surgery. In contrast to easier techniques, there is concern over reconstructive surgery using recycled tissue in terms of various problems including infection and mechanical weakness. The present report suggests that the transferred tissue with rich circulation could promote remodeling of recycled tissue as well as decreased complications such as infection.
