Audit of Surgical Complications Post-limb Salvage Procedures for Aggressive Bone Tumours at a Developing Tumour Unit
- 1Orthopaedic Surgery, Clinical Medicine, Faculty of Health Sciences, Wits University, Johannesburg, ZAF
- 2Orthopaedic Surgery, University of Limpopo, Polokwane, ZAF
Abstract
Background
The incidence of malignant bone tumours remains relatively low in our setting. However, our patients typically present late with large tumour volumes, making limb-salvage procedures difficult and prone to post-operative complications. Due to a paucity of literature in a clinical context similar to ours, we elected to assess complications experienced by our cohort of patients.
Aim & setting
We aimed to study complications experienced by our patient cohort post-limb salvage and tumour prosthesis replacement for aggressive bone tumours. This study was set at the Chris Hani Baragwanath Academic Hospital Teaching Hospital in Johannesburg from January 2017 to December 2024.
Methods
We conducted a retrospective review of records of patients who underwent limb salvage for aggressive musculoskeletal tumours at our hospital. Patients with aggressive bone tumours treated at a different unit and those who underwent revision surgery were excluded from the study. Demographic data, pathology factors, and surgery factors were extracted for analysis. Descriptive statistics were computed using Stata 18 (StataCorp LLC, College Station, Texas).
Results
A total of 20 patient records met the inclusion criteria for review. The majority of the patients were of African descent, with all age groups having an equal distribution of the burden of disease: five (0-17 years), five (18-24 years), five (25-34 years), and five (> 35 years). Osteosarcoma accounted for 45% (9/20) of diagnoses, followed by giant cell tumour (GCT) of bone. Our cohort showed a significant predilection for lower-limb involvement, with the latter accounting for 90%(18/20) of cases. Seventy percent of our patients experienced complications, with a majority of complications being prosthesis-related, such as prosthetic joint infection (PJIs) and instability.
Conclusion
The use of limb-salvage surgery with tumour prosthesis implants for malignant bone tumours is a significant achievement in bone tumour care; however, not without complications. Neurovascular injury, muscle weakness and PJIs have a predilection for the lower limb, while prosthetic instability is likely following proximal humerus resection and replacement joint. Early presentation and meticulous soft-tissue preservation could reduce our complication rate.
Contribution
The findings highlight our experience treating aggressive bone tumours with limb-salvage surgery in our clinical context.
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BibTeX
@article{kgagudi2026audit,
title = {{Audit of Surgical Complications Post-limb Salvage Procedures for Aggressive Bone Tumours at a Developing Tumour Unit}},
author = {Marule Paul Kgagudi and Maxwell Jingo and Thulani Ntshangase and Tiego Hlapolosa},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117459},
url = {https://doi.org/10.7759/cureus.117459},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Audit of Surgical Complications Post-limb Salvage Procedures for Aggressive Bone Tumours at a Developing Tumour Unit
AU - Marule Paul Kgagudi
AU - Maxwell Jingo
AU - Thulani Ntshangase
AU - Tiego Hlapolosa
PY - 2026
DA - 2026/10/05
JO - Cureus
DO - 10.7759/cureus.117459
UR - https://doi.org/10.7759/cureus.117459
AB - Background The incidence of malignant bone tumours remains relatively low in our setting. However, our patients typically present late with large tumour volumes, making limb-salvage procedures difficult and prone to post-operative complications. Due to a paucity of literature in a clinical context similar to ours, we elected to assess complications experienced by our cohort of patients. Aim & setting We aimed to study complications experienced by our patient cohort post-limb salvage and tumour prosthesis replacement for aggressive bone tumours. This study was set at the Chris Hani Baragwanath Academic Hospital Teaching Hospital in Johannesburg from January 2017 to December 2024. Methods We conducted a retrospective review of records of patients who underwent limb salvage for aggressive musculoskeletal tumours at our hospital. Patients with aggressive bone tumours treated at a different unit and those who underwent revision surgery were excluded from the study. Demographic data, pathology factors, and surgery factors were extracted for analysis. Descriptive statistics were computed using Stata 18 (StataCorp LLC, College Station, Texas). Results A total of 20 patient records met the inclusion criteria for review. The majority of the patients were of African descent, with all age groups having an equal distribution of the burden of disease: five (0-17 years), five (18-24 years), five (25-34 years), and five (> 35 years). Osteosarcoma accounted for 45% (9/20) of diagnoses, followed by giant cell tumour (GCT) of bone. Our cohort showed a significant predilection for lower-limb involvement, with the latter accounting for 90%(18/20) of cases. Seventy percent of our patients experienced complications, with a majority of complications being prosthesis-related, such as prosthetic joint infection (PJIs) and instability. Conclusion The use of limb-salvage surgery with tumour prosthesis implants for malignant bone tumours is a significant achievement in bone tumour care; however, not without complications. Neurovascular injury, muscle weakness and PJIs have a predilection for the lower limb, while prosthetic instability is likely following proximal humerus resection and replacement joint. Early presentation and meticulous soft-tissue preservation could reduce our complication rate. Contribution The findings highlight our experience treating aggressive bone tumours with limb-salvage surgery in our clinical context.
SN - 2168-8184
ER -