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En block surgery for osteogenic sarcoma: analysis and review of ninety operative cases.

This paper describes our experience in limb salvage procedures for fully malignant sarcomas done by one surgeon at Memorial Hospital. Historically, the salvage rate for even the lower grades of osteogenic sarcoma (usually juxtacortical, grade I and grade II) has been dismal for both the knee (78% failure rate) and the upper extremity (100% fail-ure). ",8",2 Symes in an early publication found a very high local recurrence rate when amputating through a joint adjacent to a fully malignant tumor. Specific operative techniques were not described in these early papers, but obviously surgery at the pseudocapsule layer is most probably doomed to failure. Fifty-four tibial and proximal fibular