Innovation in Reconstruction after Sarcoma Resection in Musculoskeletal System

Dear Colleagues,

The field of reconstructive surgery following sarcoma resection has witnessed remarkable advancements in recent years, revolutionizing the approach to limb salvage and restoration of function for patients afflicted by these debilitating malignancies. Sarcomas, comprising a diverse group of rare tumors arising from mesenchymal tissues, present formidable challenges due to their aggressive nature and propensity for local invasion. Historically, surgical management often necessitated radical resections, resulting in significant functional deficits and diminished quality of life for patients. However, the landscape of sarcoma treatment has evolved thanks to innovative techniques and technologies in reconstructive surgery. In addition to well-established microsurgical autologous reconstructive options thanks to tissue engineering approaches to cutting-edge prosthetic devices, the armamentarium available to reconstructive surgeons has expanded exponentially. These advancements not only aim to preserve limb integrity but also prioritize functional outcomes, enabling patients to regain mobility, dexterity and independence postoperatively. Central to this paradigm shift is the concept of personalized medicine, wherein treatment strategies are tailored to individual patient characteristics, including tumor location, extent of resection and functional goals. Advanced imaging modalities, such as magnetic resonance imaging (MRI) and computed tomography (CT), provide detailed anatomical information, facilitating precise preoperative planning and intraoperative navigation. Furthermore, the advent of three-dimensional (3D) printing technology allows for the creation of customized implants and surgical guides, optimizing the accuracy and efficacy of reconstructive procedures. In addition to technological innovations, there has been a paradigmatic shift toward a multidisciplinary approach, with close collaboration between surgical oncologists, reconstructive surgeons, medical oncologists, radiation oncologists and allied health professionals. This holistic model of care ensures comprehensive treatment planning, seamless coordination of interventions and holistic support for patients throughout their journey. Moreover, innovations in perioperative care, including enhanced pain management protocols, accelerated rehabilitation strategies and psychosocial support services, contribute to optimizing patient outcomes and promoting holistic recovery. By addressing the physical, emotional and functional aspects of the patient experience, reconstructive surgery after sarcoma resection transcends the mere restoration of anatomy to encompass the restoration of hope, dignity and quality of life. In this review, we explore the latest innovations in reconstructive surgery following sarcoma resection, examining the evolving landscape of surgical techniques, technological advancements and interdisciplinary collaborations. Through a comprehensive analysis of recent literature and clinical experiences, we aim to elucidate the transformative impact of innovation on patient care, outcomes and survivorship in the challenging realm of sarcoma management.

Prof. Dr. Marco Innocenti
Guest Editor

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• limb salvage in sarcoma
• free fibula after sarcoma resection
• 3D-printed prosthesis
• cryotherapy
• chest sarcoma
• soft tissue reconstruction in sarcoma
• lymphedema in sarcoma
• LVA