Palliative Surgical Management of a Metastatic Lesion of the Tibia with Extension into the Popliteal Fossa Using Polytetrafluoroethylene Felt and Bone Cement

Figure 3

Intraoperative photos. (a) Through a typical posteromedial approach to the tibia, a cortical fenestration of approximately was made to the proximal tibia (white dotted line). The lesion underwent extensive curettage under direct vision. (b) The polytetrafluoroethylene felt (black dotted line) was put in place in order to internally line the walls of the lytic cavity (black arrows point at the retracted pes anserinus). (c) Photograph taken immediately after the instillation of PMMA bone cement into the lytic cavity. PMMA bone cement filled the cavity and restored the medial tibial cortex continuity (black dotted line). Black arrows point at the retracted pes anserinus and grey arrows at the retracted gastrocnemius.

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