Standardization of rehabilitation after limb salvage surgery for sarcomas improves patients' outcome

Hematol Oncol Stem Cell Ther. 2013 Sep-Dec;6(3-4):105-11. doi: 10.1016/j.hemonc.2013.09.001. Epub 2013 Oct 24.

Abstract

Background and objective: The purpose of this study is to establish a standardized postoperative rehabilitation protocol following limb salvage surgery (LSS) in patients with primary bone sarcoma in five major anatomical locations: distal femur, proximal tibia, proximal and total femur, humerus and shoulder girdle and pelvic resections.

Setting and design: Retrospective study.

Patients and methods: All LSSs were performed by an orthopedic oncology surgeon, and rehabilitation of all patients was based on a devised standardized rehabilitation protocol. Patient outcomes were measured using the modified Musculoskeletal Tumor Society-International Symposium on the Limb Salvage (MSTS-ISOLS) scoring system.

Results: A total of 59 patients received LSS in the above mentioned locations; endoprostheses were used in 49, bone allograft in five, while no replacements were made in five patients. At a mean follow-up of 24 months, the mean modified MSTS-ISOLS score for all patients was 87% (95% CI; 0.85-0.89). The highest scores were encountered for patients with distal femur replacement: 93% (95% CI; 0.91-0.95). Seven patients had interruption of more than six weeks in their rehabilitation and had a mean score of 71% (95% CI; 0.64-0.82).

Conclusion: The proposed rehabilitation protocol is a comprehensive, organized and applicable guideline to be used after performing LSS at the above mentioned anatomical locations. The use of standardized rehabilitation protocol resulted in improved patient functional outcome.

Keywords: Limb salvage surgery; Protocol; Rehabilitation; Sarcoma.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Femur / surgery
  • Humans
  • Humerus / surgery
  • Limb Salvage / rehabilitation*
  • Limb Salvage / standards*
  • Male
  • Middle Aged
  • Pelvis / surgery
  • Reference Standards
  • Sarcoma / rehabilitation*
  • Sarcoma / surgery*
  • Tibia / surgery
  • Treatment Outcome
  • Young Adult