{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:38:56Z","timestamp":1786541936095,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limb-salvage surgery for extensive femoral osteosarcoma presents major reconstructive challenges. Conventional options such as total femoral replacement (TFR) and long-segment biological reconstructions are associated with significant complications. We evaluated the clinical outcomes of a novel hybrid approach combining a liquid nitrogen-treated autograft with a megaprosthesis (LN-MP) and compared them with those of TFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective study included 28 patients (range 8\u201324\u00a0years old) with malignant femoral bone tumors treated between 2020 and 2024. Patients underwent either LN-MP (n\u2009=\u200910) or TFR (n\u2009=\u200918). Perioperative outcomes, functional results (Musculoskeletal Tumor Society score\u2014MSTS), bone union, oncological control, and survival were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LN-MP demonstrated better functional outcomes (MSTS 27.0\u2009\u00b1\u20092.1 vs. 24.4\u2009\u00b1\u20092.2, p\u2009=\u20090.014), shorter operative time, and lower blood loss compared with TFR. Length of stay and follow-up duration were comparable. Continuous disease-free survival was higher in the LN-MP group (90% vs. 44%, p\u2009=\u20090.058), with lower recurrence (10% vs. 28%). Bone union was achieved in 70% of LN-MP cases at a mean of 9\u00a0months, with longer graft length associated with delayed union.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LN-MP reconstruction may serve as a joint-preserving alternative to total femoral replacement for patients with extensive malignant femoral tumors. In this preliminary series, LN-MP was associated with favorable functional outcomes, satisfactory graft-host bone union, and acceptable oncological results. Given the retrospective design, limited sample size, and short follow-up duration, further studies with larger cohorts and longer follow-up are required to define the role of LN-MP among contemporary limb-salvage reconstructive strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Therapeutic, Level III: retrospective comparative cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06432-y","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:09:15Z","timestamp":1786540155000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liquid nitrogen-treated autograft combined with megaprosthesis versus total femoral replacement for large-volume malignant femoral bone tumors: a comparative study"],"prefix":"10.1007","volume":"146","author":[{"given":"Nguyen Tran Quang","family":"Sang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Duc","family":"Trung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7494-8828","authenticated-orcid":false,"given":"Le Duc","family":"Huy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luu Huu","family":"Phuc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu Duc","family":"Thang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luong Nhat","family":"Anh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le The","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Thi Thu","family":"Hien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Tuyet Thanh","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duong Quang","family":"Vinh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Van","family":"Cong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Quoc","family":"Dat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0687-9509","authenticated-orcid":false,"given":"Dang Minh","family":"Quang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9954-060X","authenticated-orcid":false,"given":"Tran Duc","family":"Thanh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Trung","family":"Dung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"6432_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-43032-0_2","volume-title":"Current advances in osteosarcoma. 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