Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 10 , ISSUE 3 ( July-September, 2023 ) > List of Articles


Limb Salvage Surgery Using Autogenous Irradiated Bone Graft for Low-grade Central Osteosarcoma of the Distal Tibia: A Case Report

Ikuo Kudawara, Sumiko Yoshitatsu

Keywords : Ankle joint, Distal tibia, Irradiated bone graft, Low-grade central, Osteosarcoma

Citation Information : Kudawara I, Yoshitatsu S. Limb Salvage Surgery Using Autogenous Irradiated Bone Graft for Low-grade Central Osteosarcoma of the Distal Tibia: A Case Report. J Foot Ankle Surg Asia-Pacific 2023; 10 (3):140-144.

DOI: 10.5005/jp-journals-10040-1267

License: CC BY-NC 4.0

Published Online: 07-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: Low-grade central osteosarcoma (LGCOS) is an extremely rare variant of osteosarcoma, and its occurrence in the distal tibia is uncommon. While limb salvage surgery for a primary malignant bone tumor around a knee joint is now accepted worldwide as a standard procedure, challenges to improve the outcome for surgical treatment of lesions of the distal tibia still remain. Case description: A 26-year-old woman presented with swelling and persistent pain in her left lower leg for 6 months. Incisional biopsy demonstrated LGCOS in the distal tibia. Wide resection and reconstruction using intraoperative extracorporeal autogenous irradiated bone graft (IORBT) were performed. A cross-leg skin flap procedure was added to treat the wound complication of IORBT. There has been no evidence of disease in the last 15 years after surgery. Conclusion: The key to successful functional and oncological outcomes for the long-term in the rare case of LGCOS in the distal tibia is careful investigation before diagnosis, curative tumor resection, reconstruction using the IORBT procedure, and postoperative care, including the delay of weight-bearing and attaching of a patellar tendon-bearing (PTB) brace. Clinical significance: IORBT for the patient with LGCOS in the distal tibia is low-cost, safe, and effective.

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