Tubercle-Sparing Proximal Tibial Reconstruction in Patients with Primary and Metastatic Bone Disease A Case Report

Case: Two patients with cancer involving their proximal tibia required proximal tibial replacement (PTR). One had a softtissue sarcoma that involved her posterior cortex, and the other had extensive metaphyseal destruction from metastatic breast cancer. Their anterolateral cortex and tibial tubercle were uninvolved, permitting tubercle-sparing PTR. A plate was applied to the bone bridge in the latter patient in anticipation of radiotherapy. Both healed uneventfully and had minimal extensor lag 2 weeks postoperatively. Conclusion: Tubercle-sparing PTR preserves extensor mechanism function with minimal lag. It should be considered in patients with cancer when sparing the anterolateral cortex is oncologically safe.