Limb Salvage surgery is the preferred treatment for malignant tumours of bone. This may require resection – arthrodesis, endoprosthetic replacement or allograft reconstruction.

We have re-implanted the patient’s bone for reconstruction of the defect after debulking the tumour and irradiation in ten patients. All had grade IIB sarcomas of the pelvis, humerus, tibia and metacarpal.

Median overall survival was 24 months (maximum 69 months). Four patients are alive at the most recent follow-up. One of them has metastatic disease and local recurrence while others remain free of disease. One patient has had pathological fracture through the irradiated bone that healed with conservative measures. One developed avascular necrosis of the femoral head and required resurfacing arthroplasty of the hip.

The pelvic sarcoma continues to be a challenge. Resection, extracorporal irradiation and re-implantation may offer some hope but remain experimental.