Outcomes of Limb Salvage Surgery Versus Amputation for Osteosarcoma of the Long Bones at National Orthopaedic Hospital, Igbobi, Lagos

Osteosarcoma is the most common primary malignant bone tumour in adolescents and young adults, requiring complex interdisciplinary management including resection, reconstruction, and chemotherapy. In high-income countries, limb salvage surgery (LSS) has become the preferred approach, but in sub-Saharan Africa, delayed presentation and resource limitations frequently necessitate amputation. This retrospective cohort study compares survival outcomes, complication rates, and functional outcomes between patients who underwent LSS and those who underwent amputation for osteosarcoma of the long bones at the National Orthopaedic Hospital, Igbobi, Lagos, South West Nigeria, over a ten-year period. Case records will be reviewed for tumour site, Enneking surgical stage, chemotherapy received, surgical margins, and outcomes including five-year survival, local recurrence, metastasis, and functional status at final follow-up using the Musculoskeletal Tumour Society (MSTS) score. Kaplan-Meier survival analysis and Cox proportional hazards regression will be used. The study hypothesises that overall survival does not differ significantly between groups when tumour stage is controlled. Findings will inform orthopaedic oncology decision-making algorithms at the national centre and contribute to the limited but growing sub-Saharan African musculoskeletal oncology literature. Keywords: osteosarcoma, limb salvage surgery, amputation, MSTS score, bone tumour.