Metastatic Bone Disease: Femur and Tibia

Metastatic adenocarcinoma to the tibia can be a complicated problem that may be difficult to manage. However, reasonably good functional results are possible when managed with an appropriate team of cancer care professionals with a treatment algorithm tailored for each individual patient. As opposed to that of the proximal femur, humerus, and axial skeleton, metastatic disease to the tibia is historically seen at later stages in the primary disease process. As a result, standard treatment protocols and algorithms for tibial disease are less specifically defined in the literature as compared to those of the other appendicular long bones. Therefore, the data are limited given short-term follow-up and the lower frequency of problems related to tibial disease. However, due to improvements in medical therapies, alternative methods of stabilization, and megaprosthetic modularity, both quality of life and function can be preserved, so long as an appropriately aggressive algorithmic approach to the site of disease is taken.