The Orthoncology Clinic — Dr Srimanth B S
Services · Limb Salvage Surgery

Removing the cancer. Preserving the limb.

Limb salvage surgery removes cancerous bone or soft tissue in the arms or legs while preserving limb function. Advances in chemotherapy, radiotherapy, imaging and reconstructive implants have transformed care — from routine amputation to limb preservation in ≈95% of cases.

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Why limb salvage over amputation?

  • Oncologic safety

    Complete tumour removal with healthy margins — local control rates above 95%.

  • Function preservation

    Reconstruction restores joint motion, weight bearing and independence.

  • Quality of life

    Patients retain self-image and return to daily activities and work.

Who qualifies?

Nearly every patient with a limb sarcoma is a candidate

The decision is made together — by you, your family and a sarcoma team — once we have the imaging, biopsy and response to neoadjuvant therapy in front of us.

  • No extensive skin or muscle invasion precluding coverage
  • No unreconstructable neurovascular involvement
  • Acceptable response to neoadjuvant therapy
  • Patient consent after understanding risks and benefits
Patient journey

From first scan to surgery

Every step is planned by a multidisciplinary team — so the surgical decision is the best one for your tumour and your life.

  1. 1Step 1

    History & imaging

    X-rays, MRI, CT chest and PET-CT / bone scan for staging.

  2. 2Step 2

    Biopsy

    Image-guided core needle or open biopsy by the treating surgeon.

  3. 3Step 3

    Multidisciplinary planning

    Tumour board with medical, radiation oncology, pathology and reconstruction.

  4. 4Step 4

    Neoadjuvant therapy

    Chemotherapy ± radiotherapy to shrink tumour and improve margins.

  5. 5Step 5

    Patient counselling

    Reconstruction options, expected function and rehabilitation plan.

Case videos

Real patients. Real outcomes.

Three short case walkthroughs showing how planning, surgery and rehabilitation come together in everyday practice.

Case 1 — Proximal femur chondrosarcoma

Limb salvage with tumour megaprosthesis reconstruction.

Case 2 — Pelvic chondrosarcoma

Limb-sparing internal hemipelvectomy and return to activity.

Case 3 — Relapsed giant cell tumour of distal radius

Limb-saving surgery with wrist fusion and ulna translocation.

Case highlights

Three limb salvage stories

Curated case posters showing diagnosis, surgical plan and recovery — published from The OrthOncology Clinic.

Telangiectatic osteosarcoma of femur in 18-year-old — pre-op X-ray, MRI, post-op X-ray and follow-up at 10 months

Case 1 — Telangiectatic osteosarcoma of femur

Diagnosis
18-year-old, non-metastatic osteosarcoma of distal femur with large soft-tissue component and impending pathological fracture.
Surgery
Limb salvage surgery with cemented tumour megaprosthesis after neoadjuvant chemotherapy.
Outcome
Independent ambulation and return to college at 10-month follow-up.
Limb-saving internal hemipelvectomy for Ewing's sarcoma of right hemipelvis in a teenager — pre-op imaging, post-op X-ray and follow-up

Case 2 — Ewing's sarcoma of pelvis

Diagnosis
Teenager with non-metastatic Ewing's sarcoma of right hemipelvis (ilium and acetabulum), large extra-osseous component crossing the midline.
Surgery
Limb-saving internal hemipelvectomy (Type 1 + partial 2 + 4) with mesh pseudoarthrosis reconstruction after 4 cycles of neoadjuvant chemotherapy.
Outcome
Walking with support and cycling at 6-month follow-up.
Limb-sparing surgery for chondrosarcoma of scapula — pre-op clinical photo, post-op X-ray and patient riding a bike at 3 months

Case 3 — Chondrosarcoma of scapula

Diagnosis
Left-handed electrician with a year-long left shoulder swelling — CT-guided biopsy confirmed non-metastatic chondrosarcoma of scapula involving glenoid and shoulder muscles.
Surgery
Total scapulectomy with clavicle–humerus suspension; biological/prosthetic reconstruction was avoided due to insufficient muscle for shoulder function.
Outcome
Retained elbow and wrist–hand function and back to riding a bike by 3 months post surgery.
Reconstruction options

Four techniques — chosen for your tumour and your life

Decision factors include tumour location, age and growth potential, functional needs, cosmetic considerations, bone stock and soft-tissue envelope.

Megaprosthesis

Tumour Endoprosthesis Reconstruction

Large metallic implants restore bone and joint segments after resection — including expandable implants for children and 3D-printed custom designs.

  • Standard, modular and expandable systems
  • Immediate weight bearing for cemented implants
  • 10-year survival 58–66%
Read the full guide
Biological

Biological Reconstruction

Autograft, allograft, recycled tumour bone and 3D-printed solutions that promote natural healing and avoid long-term implant wear.

  • Vascularised fibula and massive allograft
  • Extracorporeal irradiated autograft (ECRT)
  • Union rates above 80% in expert hands
Read the full guide
Composite & technology

Graft–Prosthetic Reconstruction & Advanced Planning

Composite reconstructions combined with patient-specific instrumentation, 3D printing, surgical navigation and augmented reality.

  • PSI accuracy to within 1–2 mm
  • 30% reduction in operative time
  • AR / navigation cuts cutting errors by ~50%
Read the full guide
Van Ness procedure

Rotationplasty

A durable, biologic limb-salvage option for children and young adults — the ankle is rotated to function as a knee, giving lifelong high-level function.

  • MSTS scores 85–90%
  • 10-year survival 85–90%
  • 60% return to non-contact sports
Read the full guide

What outcomes can I expect?

  • Prosthetic reconstructions: immediate weight bearing, knee motion typically 0–120°.
  • Biological reconstructions: delayed weight bearing (6–9 months) until graft union.
  • Rotationplasty: excellent function, participation in sports; unique cosmetic appearance.
  • Survival: limb salvage does not compromise oncologic outcomes — 5-year survival is similar to amputation.

Risks and complications

All major surgery carries risk. With sarcoma expertise these are minimised and actively managed.

  • • Infection (5–10%)
  • • Prosthetic loosening or fracture (10–15%)
  • • Nonunion in grafts (10–20%)
  • • Wound healing delays, lymphoedema
  • • Rare secondary malignancy in irradiated grafts

Take-home summary

Limb salvage surgery offers oncologically safe tumour removal with function-preserving reconstruction for most patients with limb sarcomas. Personalised planning by a multidisciplinary team — combined with advances in implants and biological techniques — delivers excellent survival and quality-of-life outcomes.

Book an Appointment

References

  1. Strauss DC et al. Impact of specialised sarcoma care on outcomes. Ann Surg Oncol. 2014;21(13):4418–4427.
  2. Pisters PW et al. Rationale for radiation therapy in extremity STS. Ann Surg Oncol. 2007;14(3):1081–1087.
  3. PMC7315319 — Extracorporeal irradiated autograft reconstruction outcomes. PubMed Central, 2020.