Can osteosarcoma occur on the knee?

Written by Na Hong Wei
Orthopedics
Updated on September 16, 2024
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Can osteosarcomas grow on the knee? In fact, the locations where osteosarcomas commonly appear are indeed near the knee. There are mainly three common sites: the most prevalent is the distal end of the femur, the lower part of the thigh bone. The second most common site is the proximal end of the tibia. The third is the proximal end of the humerus. Therefore, osteosarcomas usually do grow near the knee. What are the symptoms of an osteosarcoma? The symptoms of osteosarcoma include, first, localized pain, which is a constant pain that persists, worsens, and does not alleviate, often causing night pain, and many patients do not feel pain during the day, only at night. The second symptom is a localized lump, generally spindle-shaped, with an increased skin temperature over the surface, and even distended veins due to the tumor restricting nearby joint movement. The third symptom is the appearance of cachexia or wasting syndrome throughout the body. The fourth point is that the growth of the osteosarcoma leads to erosion of the bone and eventually pathologic fractures. Thus, the likelihood of osteosarcomas appearing near the knee is very high, and many patients typically come to the hospital because of painful lumps near the knee, and then, after examination, the diagnosis is confirmed.

Other Voices

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Written by Cheng Bin
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Is osteosarcoma highly malignant?

First of all, it is certain that osteosarcoma is very malignant. Once osteosarcoma is detected, it is necessary to actively prepare for surgery, rule out surgical contraindications, and then proceed with surgical treatment. During the surgery, efforts should be made to perform an extended resection, and if necessary, amputation may be required. After the surgery, the excised specimen must be sent for pathological examination to determine the pathological type. Then, based on the examination results, effective radiotherapy and chemotherapy should be chosen to control the possibility of recurrence or metastasis of osteosarcoma and to extend the patient's life as much as possible.

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incidence of osteosarcoma

Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone and has a relatively high incidence rate. Among primary bone tumors, the incidence of osteosarcoma is second only to plasma cell myeloma, ranking second. Osteosarcoma typically occurs in tubular bones, commonly affecting the rapidly growing metaphyseal regions. The distal femur, proximal tibia, and proximal humerus are the most frequently affected sites. Between 50%-70% of all cases occur around the knee joint. The common age range for this disease is between 10 to 20 years old, with a higher prevalence in males than in females.

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Written by Guan Jing Tao
Orthopedics
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Does osteosarcoma spread through blood?

As far as we know, osteosarcoma is not transmitted through blood or infectious. If osteosarcoma had such infectious characteristics, it would be transmitted in the same way as AIDS or other sexually transmitted diseases and would be classified as a contagious disease. However, there has been no notification or relevant guidelines to date indicating that osteosarcoma can be transmitted through blood. Therefore, normal contact with patients with osteosarcoma, or caring for patients with osteosarcoma, including sharing the same food or coming into contact with their blood, generally does not lead to the transmission or contraction of osteosarcoma.

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Written by Guan Yu Hua
Orthopedic Surgery
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What is the basis for the diagnosis of osteosarcoma?

Let's briefly describe osteosarcoma, which is a malignant tumor of the bone, most commonly found in adolescents and young adults, typically occurring near the proximal end of the tibia, the distal end of the femur, or the proximal end of the humerus, mainly growing at the epiphyseal ends. In the early stages, patients show no symptoms, with the most common symptom being pain, usually discovered in the middle to late stages. This pain tends to be persistent and is most pronounced at night. Some patients may also have a local mass. Osteosarcomas are highly prone to early lung metastases. Additionally, the surface skin temperature may increase, veins may become distended, and there may be a presence of cachexia as the disease progresses, leading to severe thinness and weakness in the body. The primary diagnostic basis is radiographic examination, which might show unique signs such as Codman’s triangle under sun-ray exposure, indicative of osteosarcoma. If the radiographic signs are not typical, further differentiation can be done using CT scans or MRI. The most crucial matter is surgical biopsy for a definitive diagnosis, mainly based on the postoperative pathology. Intraoperative measures like cryosurgery can be performed. Upon discovery, limb amputation is generally recommended, although limb-sparing surgeries can be considered, involving techniques like resection followed by reimplantation or prosthetic implantation. Overall, the prognosis is typically poor, but with the rapid advancement in chemotherapy, the five-year survival rate can improve somewhat, generally around 50%.

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Are osteosarcomas sensitive to radiotherapy and chemotherapy?

Osteosarcoma is generally insensitive to radiotherapy, hence radiation therapy is not used for such diseases in clinical settings. Similarly, these diseases have a moderate sensitivity to chemotherapy, necessitating the use of relatively high doses of chemotherapy during treatment. The main mechanism of chemotherapy involves using a series of cytotoxic drugs to inhibit tumor growth. Although high-dose chemotherapy can effectively kill tumor cells, it can also damage some of the patient's normal cells, leading to severe reactions. If radical surgery is viable for these patients, then curative surgery is the preferred method of treatment.