Objective: To compare and analyze the therapeutic effects of X-ray devitalization and replantation and alcoholic devitalization and replantation in adolescent patients with lower limb osteosarcoma.
Methods: We collected clinical data for 43 osteosarcoma patients with limb salvage treatment treated in our hospital from February 2014 to February 2018. The patients were divided into x-ray devitalization and replantation group (n=23) and alcoholic devitalization and replantation group (n=20) based on the treatment methods. The two groups were compared in operation duration, intraoperative blood loss, postoperative fracture healing time, length of tumor bones, MSTS score and ISOLS score, postoperative complications, postoperative follow-ups and postoperative recurrence and metastases.
Results: Operation duration and intraoperative blood loss of the alcoholic group were less than that of the X-ray group, while postoperative fracture healing time of the alcoholic group was longer than that of the X-ray group (P<0.05). For the X-ray group, MSTS score and ISOLO score of the final follow-up were 26.13±2.65 and 32.53±3.73 respectively. For the alcoholic group, MSTS score and ISOLO score of the final follow-up were 23.69±3.27 and 30.98±3.56 respectively. MSTS score of the X-ray group was higher than that of the alcoholic group (P<0.05). There were 2 cases of internal fixation failure and 2 cases of adhesive knee joints stiffness in the X-ray group. As for the alcoholic group, there were 2 cases of internal fixation failure and 2 cases of incision soft tissue infection. There were no statistically significant differences in postoperative complications, recurrence, and metastases between the two groups (P>0.05).
Conclusion: Both methods are convenient, inexpensive, and effective for adolescent patients with lower limb osteosarcoma. Alcoholic devitalization and replantation results in shorter operation duration and less intraoperative blood loss, while X-ray devitalization and replantation results in better postoperative limb function restoration.
Keywords: X-ray devitalization and replantation; alcoholic devitalization and replantation; lower limb; osteosarcoma (OS).
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