Functional outcome after surgery in patients with bone sarcoma around the knee; results from a long‐term prospective study

Abstract

Background and ObjectivesIn a previous conducted study functional outcome of young patients with bone sarcoma located around the knee was longitudinally evaluated during the first 2 years postoperatively. Functional outcome improved significantly over the first 2 years. The purpose of this descriptive study was to evaluate the functional outcome of these patients at long‐term follow‐up of 7 years.MethodsFunctional outcome was assessed with the TESS, MSTS, Baecke questionnaire, and three functional performance tests: time up and down stairs (TUDS), various walking activities (VWA), and the 6‐min walking test (6MWT). Linear Mixed Model has been employed for the repeated measurements.ResultsTwenty patients of the original study (n = 44) participated in the current study. Fifteen limb‐salvage and five ablative surgery patients, median follow‐up 7.4 years (6.8‐8.0) (CI 95%), mean age 22.3 years (18.2‐31.6). Between 2 and 7 years after surgery, 8 limb‐salvage patients (53%) encountered surgery related complications. Questionnaires and functional performance tests showed no significant difference in functional outcome between 2 years and 7 years after surgery (P < 0.05).ConclusionsBetween 2 years and follow‐up at average 7 years after surgery no further improvements were noticed at young patients with a bone sarcoma located around the knee.

Using the Barthel Index to Assess Activities of Daily Living after Musculoskeletal Tumour Surgery: A Single-centre Observational Study

“…In addition to the Musculoskeletal Tumour Society Score and the Toronto Extremity Salvage Score, several new evaluation scales have been developed in recent years, and some have also been used for musculoskeletal tumours. [30][31][32][33][34] However, these methods of evaluation are disease-specific, and a generalized evaluation method remains to be developed for future evaluations. Davis et al reported that the Musculoskeletal Tumour Society Score and the Toronto Extremity Salvage Score demonstrate a significant correlation.…”

Avaliação funcional retrospectiva de pacientes com tumor ósseo tratados com endoprótese

“…Independentemente da presença de liberação, ou do tipo de reinserção, ocorre diminuição da força muscular dos flexores e extensores do joelho (KENDALL et al, 2000). Poucos estudos avaliam em detalhe a força muscular nessas diferentes situações (TSUBOYAMA et al, 1993;PETSCHNIG et al, 1995;BENEDETTI et al, 2000;PILGE et al, 2015) e comparam entre os tipos de reconstruções (BERNTHAL et al, 2015).…”

“…Nossos resultados mostram reduções do pico de torque de 77,5% para extensão e 21,9% para flexão do joelho em relação ao membro não operado. Estudos anteriores relataram redução da força extensora do joelho de 52,6% a 91,0% (TSUBOYAMA et al, 1993;PETSCHNIG et al, 1995;BENEDETTI et al, 2000;BERNTHAL et al, 2015; PILGE et al, 2015). Neste estudo, não houve diferença na redução do pico de torque quando comparadas as ressecções femorais e tibiais.…”

“…Clinicamente esses pacientes costumam apresentar fraqueza maior para extensão do que para flexão (KENDALL et al, 2000). Nas ressecção distais do fêmur foi encontrado déficit de 21% do torque flexor, no entanto, na literatura os déficits encontrados apresentam grande variação de 2,1% a 50,8% (TSUBOYAMA et al, 1993;BEEBE et al, 2009;BERNTHAL et al, 2015). Para ressecções proximais da tíbia tivemos redução de 36% na força flexora, que foi similar ao encontrado por Bernthal et al, (2015) e Petschnig et al, (1995.…”

“…No entanto, poucos estudos abordam o resultado da força muscular. Na literatura, nas reconstruções do joelho, encontramos redução da força extensora entre 52% a 90% (TSUBOYAMA et al, 1993;PETSCHNIG et al, 1995;BENEDETTI et al, 2000;BERNTHAL et al, 2015;PILGE et al, 2015), enquanto para as reconstruções do quadril encontramos que pacientes com reconstruções da musculatura abdutora, diretamente na prótese, apresentaram redução da força de 8% comparada ao membro contra-lateral (GIUREA et al, 1998).…”