Knee Hemiarthroplasty as a Reconstructive Option for Distal Femoral Sarcoma in Skeletally Immature Patients: Mid-Term Outcomes

Objectives: Limb-salvage procedures in pediatric patients with malignant bone tumors around the knee are surgically challenging due to the need for skeletal growth preservation and long-term functional demands. Hemiarthroplasty has emerged as a potential solution when other reconstruction options are limited or unfeasible. Methods: We present a retrospective case series of three skeletally immature patients (ages ۵-۷) with high-grade malignant tumors of the distal femur. All underwent wide tumor resection followed by reconstruction using a hemiarthroplasty. Functional outcomes were assessed using the Enneking scoring system. Follow-up ranged from ۳ to ۵ years. Results: All patients achieved limb preservation with good early functional recovery. The mean Enneking functional score was ۲۳/۳۰ (range, ۲۱-۲۵). Two patients remain disease-free with stable implants at the latest follow-up. One patient experienced pulmonary relapse and died ۴ years after surgery. No local recurrences or mechanical implant failures were observed. Conclusion: Hemiarthroplasty is a viable and cost-effective reconstructive option in pediatric patients with distal femoral sarcoma, particularly in settings where expandable endoprostheses are unavailable or contraindicated. Mid-term outcomes demonstrate acceptable oncologic safety and functional results. Larger studies are needed to validate its role as a standard reconstructive technique. Level of evidence: IV

کلیدواژه ها:

Distal femur ، Enneking score ، Hemiarthroplasty ، Limb salvage ، pediatric bone tumors ، Reconstruction