PMC9941032_01
MRI (A) and radiograph (B) of the tibia. . MRI: magnetic resonance imaging.
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FIG1
Magnetic resonance imaging (MRI) and radiographs demonstrated an aggressive tumor with multiple areas of extraosseous extension (Figure 1A and B).
Histologic images from high-grade chondrosarcoma, H&E stains. (A) Low-power view demonstrates tumor percolation or perfusion through bone, a growth pattern indicative of malignancy in chondrosarcoma (20x magnification). (B, C) Areas of the tumor demonstrate chondrocyte hypercellularity and cytologic atypia, to a degree diagnostic of high histologic grade (B: 200x magnification, C: 400x magnification).
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FIG2
Radiograph after resection of tumor and placement of spacer.
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FIG3
In the first stage, the tumor was resected, and the defect was temporarily reconstructed with an antibiotic-laden cement spacer (Figure 3).
Radiographs of prosthetic (A) and the stem (B, C) for the tibial megaprosthesis.
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FIG4
The custom stem to hold the tibial megaprosthesis in place was designed by the company as a cylindrical uncemented stem with proximal ingrowth, a collar, and interlocking holes similar to a traditional TTC fusion nail (Figure 4).
Radiographs of the failed stem (A, B).
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FIG5
Intraoperative photographs (A, B) and postoperative radiograph (C) of the custom stem based on a senior author's design.
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FIG6
It included a collar, threads, and interlocking holes and was successfully implanted after the fabrication of the implant (Figure 6).
Radiograph demonstrating the stability of the stem at 2.5 years after implantation.
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FIG7