Wide resection, freezing and implant retention (WFIR) for recurrent bone and soft tissue tumor of the limbs: A case series.

BackgroundRe-excision for recurrent bone and soft tissue tumor involves increased surgical morbidity, often with significant bone and soft tissue loss associated with removal of indwelling implants. The case series demonstrates Wide resection, freezing and implant retention (WFIR) after recurrent bone and soft tissue tumor with previous implant retention.MethodsA retrospective review was conducted on 11 consecutive patients who underwent WFIR for recurrent extremity musculoskeletal tumors between July 2011 and July 2023 at a tertiary referral center in Taipei, Taiwan. All procedures were performed by a single fellowship-trained musculoskeletal oncologic surgeon, with diagnoses confirmed by two independent pathologists. Outcomes included implant survival, local recurrence, infection, wound complications, reoperation, and amputation. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) score. Additionally, 2-year limb preservation and local recurrence rates were recorded.ResultsEleven patients (mean age 46 years) were included, with the femur being the most common site (n=9). Osteosarcoma was the most frequent diagnosis (n=5). Four patients had prior unplanned excisions. Two patients underwent amputation due to recurrence or infection. Implant retention was achieved in 81.8% of cases, with a local recurrence rate of 9.1%. Implant retention was achieved in the remaining cases without major complications. The mean MSTS score was 95.2%.ConclusionWFIR provides satisfactory implant retention, acceptable oncological control, and favorable functional outcomes in recurrent musculoskeletal tumors, and may reduce morbidity associated with implant removal and extensive tissue loss.