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approach is more time consuming and may be more challenging in cases with parts of the femoral head in contact with the acetabulum. Some authors



 

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Bhabhi Pedia book 2 movie free download Bhabhi Pedia book 2 movie free download in the average postoperative configuration. However, the latter approach is more time consuming and may be more challenging in cases with parts of the femoral head in contact with the acetabulum. Some authors suggested preserving autologous cartilage for filling type 4 and 6 defects,^[@R3]^ whereas others advocate a more conservative treatment, such as the use of porous tantalum implant^[@R14]^ or osteochondral autograft,^[@R9]^ combining extensive bone grafting, using an accessory anterolateral bone block, with a piece of articular cartilage. We did not use cartilage reconstruction to fill osteochondral defects because of the small size of the joint defect and the thickness of the native cartilage. The soft tissue defect would have resulted in a poor outcome. This study has several limitations. First, the survival time of the patients was mainly determined by tumor-related complications; thus, the assessment of recurrence and survival was not performed. Second, all patients received preoperative bisphosphonate medication to reduce the occurrence of postoperative complications; however, the exact dosage of medication cannot be obtained, and the effect of bisphosphonate on osteosarcoma remains unclear. Third, the sample size of the 2 groups was relatively small. Because of the limited number of patients, the survival difference could not be assessed. Fourth, we used the same surgical approach and technique in both groups and this may lead to the selection bias. Porous ceramic implant has been reported in a level 1 study with encouraging results.^[@R10]^ We are concerned about the advantages of this technique in osteosarcoma lesions. Furthermore, we were unable to assess whether the approach of femoral head preservation is more advantageous in osteosarcoma, as most cases were due to osteomyelitis. The 5-year follow-up revealed encouraging functional outcomes, with excellent integration and restoration of the joint architecture, but most of our follow-up were more than 6 years. Further studies with longer follow-ups are needed to identify the advantage of the approach of femoral head preservation in osteosarcoma. Finally, it is difficult to predict the survival and functional prognosis of patients with osteosarcoma. This study is a single-center study. In addition, it is a retrospective study, thus,




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