Dacron fabric-enveloped alumina ceramic prosthesis for cementless resection arthroplasty of the proximal tibia: a case report with a long-term result.

After resection of the primary lesion, the right proximal tibia of a patient with osteosarcoma was reconstructed using a Dacron fabric-enveloped alumina ceramic total knee prosthesis without cement. Dacron fabric is intended to act as a scaffold upon which connective tissue can proliferate and form new ligament and other supporting soft tissues. Usually, following wide resection of the primary lesion, the supporting system is lost. If the supporting soft tissues are not reconstructed after removal of the tumor, they will be fixed in a slackened condition and will not provide sufficient support, leading to problems of stability and function. Using alumina ceramics alone does not induce surrounding connective tissue formation; therefore, stability is not ensured. The support of the vascular tissue enables the fabric to carry out the functions of ligaments, tendons, retinaculum, periosteum, joint capsule and other supporting soft tissues. Over time, stabilization occurs, biologic fixation of the prosthesis to the supporting soft tissues is successful and the durability of the prosthesis is prolonged. Postoperative follow-up has continued for a 77-month period. At present, the patient continues to show no evidence of disease and is able to walk painlessly up and down stairs without using a knee brace or handrail. A knee brace was recommended, however, to ensure the durability of the prosthesis. Dacron fabric is useful for the repair of supporting soft tissues without significant complications. Using this unique method, a stable, functional and aesthetically pleasing reconstruction can be accomplished.