Limb-saving therapy for primary bone tumours is the treatment of choice. We aimed at analysing the quality of life of this group of patients by combining three different tools. Eighty-seven patients (46 females, 41 males) with a primary bone tumour of the extremity who had undergone endoprosthetic reconstruction between 1982 and 2000 were included in this retrospective study. The median age at the time of evaluation was 30 (12-73) years. The Toronto Extremity Salvage Score (TESS) and the Reintegration to Normal Living index (RNL) were recorded an average of 5.8 years after reconstruction and the Musculoskeletal Tumour Society Score (MSTS) after an average of 6.5 years. The mean MSTS score was 77% (13-93%). The mean TESS was 82% (22-99%), and the mean RNL index was 87% (32-98%). The subjective satisfaction and acceptance of physical impairment were significantly higher than the objective score (p<0.001). The TESS was 88% in patients aged 12-25 years, 81% in those aged 26-40 years and 57% in those aged 41-73 years. Parallel recording of the MSTS score, TESS and RNL index provides a better measure reflecting the complex situation of the patients by combining objective and subjective parameters.

Multimodal, limb-saving therapy is the treatment of choice in children with osteosarcoma. However, few data are available on long-term functional problems and disabilities in surviving patients. Seventy-eight children treated for Stage II-B osteosarcoma who were treated between 1970 and 1997 were evaluated. Beyond the clinical examination, functional results were assessed using the scoring system of the Musculoskeletal Tumor Society. Patients reported their physical disabilities when completing the Toronto Extremity Salvage Score. The most recent cohort of patients who had tumor resection combined with preoperative and postoperative chemotherapy had the best 10-year survival rate at 70%. Thirtyfour children (44%) were treated by limb-sparing therapy with 25 children requiring an endoprosthesis. Ten of these 25 children (40%) required one or in some cases several replacements of the endoprostheses because of complications. The original prostheses were in place for a median of 4.9 years before the first exchange (range, 2.0-12.0 years). Evaluations with rating scales showed that the subjective estimation of disabilities by the Toronto Extremity Salvage Score was significantly higher than a rating of limb functions by a doctor using the Musculoskeletal Tumor Society score. Best results were observed in children with an endoprosthesis of the distal femur who achieved as much as 90% ability to do their daily life routine. Limb-saving therapy in children with osteosarcoma enables a return to activities of daily living in long-term survivors with a minimum of remaining disability.

No abstract

No abstract