(1) Background: We aim to address the following questions. What was the complication rate of vascularized fibula graft (VFG) combined with massive allograft in patients treated with joint-sparing resection around the knee for a high-grade osteosarcoma? What was the long-term survivorship of VFG free from revision and graft removal? What were the functional results as assessed by the Musculoskeletal Tumor Society (MSTS) score? (2) Methods: 39 patients treated in our unit for osteosarcoma around the knee with intercalary resection and reconstruction with VFG combined with massive allograft were included; 26 patients underwent intercalary tibial resection, while 13 underwent intercalary femoral resection. (3) Results: Mean Follow-Up was 205 months (28 to 424). Complications that required surgery were assessed in requiring surgical revision in 19 patients (49%) after a mean of 31 months (0 to 107), while VFG removal was necessary in three patients (8%). The revision-free survival of the reconstructions was 59% at 5 years and 50% at 10 to 30 years. The overall survival of the reconstructions was 95% at 5 to 15 years and 89% at 20 to 30 years. The mean MSTS score was 29.3 (23 to 30). (4) Conclusions: VFG represents an effective reconstructive option after joint-sparing intercalary resection around the knee for osteosarcoma.
（1）背景：本研究旨在探讨以下问题：对于接受膝关节周围保留关节切除术治疗高级别骨肉瘤的患者，采用带血管蒂腓骨移植（VFG）联合大块同种异体骨移植的并发症发生率是多少？VFG免于翻修及移植物取出的长期存活率如何？通过肌肉骨骼肿瘤协会（MSTS）评分评估的功能结果如何？（2）方法：纳入39例在我科接受膝关节周围骨肉瘤节段性切除并采用VFG联合大块同种异体骨移植重建的患者；其中26例接受胫骨节段性切除，13例接受股骨节段性切除。（3）结果：平均随访时间为205个月（28至424个月）。19例患者（49%）平均在术后31个月（0至107个月）出现需手术处理的并发症，其中3例（8%）需移除VFG。重建术后免翻修生存率在5年为59%，10至30年为50%。总体重建生存率在5至15年为95%，20至30年为89%。平均MSTS评分为29.3分（23至30分）。（4）结论：VFG是膝关节周围骨肉瘤行保留关节的节段性切除术后有效的重建选择。
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