Functional assessment of endoprosthesis in the treatment of bone tumors

Fukumothi, Denis Kiyoshi; Pupo, Hiran; Reganin, Luciano Augusto; Matte, Silvia Raquel Fricke; Lima, Bruno Spagnuolo de; Mattos, Carlos Augusto de

doi:10.1016/j.rboe.2016.08.012

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Revista Brasileira de Ortopedia

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ORIGINAL ARTICLES • Rev. bras. ortop. 51 (05) • Sep-Oct 2016 • https://doi.org/10.1016/j.rboe.2016.08.012 copy

Functional assessment of endoprosthesis in the treatment of bone tumors^☆ ☆ Study carried out at the Pontifícia Universidade Católica de Campinas (PUC-Campinas), Hospital e Maternidade Celso Pierro, Serviço de Ortopedia e Traumatologia, Campinas, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVES:

Evaluate the functional grade of these patients and to identify the types of complications found that influenced the average life span of endoprostheses the functions of the operated limb.

METHODS:

We analyzed 14 post-operative cases of endoprosthesis, patients with malignant bone tumors and aggressive benign bone tumors submitted to surgery between 2004 and 2014. The evaluation system used was proposed by Enneking, recommended by the Musculoskeletal Tumor Society (MSTS), in addition to the radiologic evaluation.

RESULTS:

Endoprosthesis are excellent choices for the treatment of bone tumors with limb preservation in relation to pain, strength, and patient's emotional acceptance. Another factor for good results is the immediate weight-bearing capacity, generating a greater independence.

CONCLUSION:

The authors conclude that all patients classified the therapy as excellent/good, regardless of the type of prosthesis used, extent of injury, and/or type of tumor resection performed.

Keywords:
Bone neoplasms; Reconstructive surgical procedures; Joint prosthesis; Limb salvage

Patient	Gender	Age	Surgery	Site	Primary tumor	Amputation
1	M	41	2004	Knee	GCT	No
2	M	52	2008	Hip	Chondrosarcoma	No
3	F	61	2008	Knee	Chondrosarcoma	Yes
4	F	66	2008	Knee	Chondrosarcoma	No
5	M	58	2010	Knee	Chondrosarcoma	Yes
6	F	81	2011	Knee	Metastasis	No
7	F	28	2012	Knee	GCT	No
8	F	60	2013	Knee	Metastasis – Breast	No
9	F	74	2013	Knee	Chondrosarcoma	Yes
10	M	65	2014	Shoulder	Chondrosarcoma	No
11	F	56	2014	Hip	Metastasis – Kidney	No
12	M	19	2014	Knee	Ewing Sarcoma	No
13	F	49	2014	Knee	Multiple Myeloma	No
14	F	31	2014	Knee	GCT	No

Patient	Pain	Function	Emotional acceptance	Supports	Walking	Gait	Strength	ROM
1	3	5	4	6	5	4	6	2
2	6	5	6	2	4	3	6	5
3	–	–	–	–	–	–	–	–
4	4	4	6	1	3	2	4	6
5	–	–	–	–	–	–	–	–
6	6	2	6	2	3	2	6	3
7	6	5	4	6	6	4	6	5
8	6	2	6	1	2	2	6	6
9	–	–	–	–	–	–	–	–
10	4	1	4	6	–	–	0	0
11	4	3	5	1	3	2	6	4
12	5	5	4	6	5	5	6	4
13	4	3	2	3	4	3	6	5
14	3	3	6	6	6	2	6	2

Patient	Mean of scores
1	4.375
2	4.625
4	3.75
6	3.75
7	5.25
8	3.875
10	1.875
11	3.5
12	5
13	3.75
14	4.25

Results of the mean comparison test
Variable	Effective	p-Value
Pain	Yes	0.001
Function	No	0.150
Emotional acceptance	Yes	0.005
Supports	No	0.200
Walking	No	0.100
Gait	No	0.800
Strength	Yes	0.001
ROM	No	0.090
Total	Yes	0.002

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: lucianoreganin@uol.com.br(L.A. Reganin).

Patient	Pain	Function	Emotional acceptance	Supports	Walking	Gait	Strength	ROM
1	3	5	4	6	5	4	6	2
2	6	5	6	2	4	3	6	5
3	–	–	–	–	–	–	–	–
4	4	4	6	1	3	2	4	6
5	–	–	–	–	–	–	–	–
6	6	2	6	2	3	2	6	3
7	6	5	4	6	6	4	6	5
8	6	2	6	1	2	2	6	6
9	–	–	–	–	–	–	–	–
10	4	1	4	6	–	–	0	0
11	4	3	5	1	3	2	6	4
12	5	5	4	6	5	5	6	4
13	4	3	2	3	4	3	6	5
14	3	3	6	6	6	2	6	2

Patient	Pain	Function	Emotional acceptance	Supports	Walking	Gait	Strength	ROM
1	3	5	4	6	5	4	6	2
2	6	5	6	2	4	3	6	5
3	–	–	–	–	–	–	–	–
4	4	4	6	1	3	2	4	6
5	–	–	–	–	–	–	–	–
6	6	2	6	2	3	2	6	3
7	6	5	4	6	6	4	6	5
8	6	2	6	1	2	2	6	6
9	–	–	–	–	–	–	–	–
10	4	1	4	6	–	–	0	0
11	4	3	5	1	3	2	6	4
12	5	5	4	6	5	5	6	4
13	4	3	2	3	4	3	6	5
14	3	3	6	6	6	2	6	2

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Functional assessment of endoprosthesis in the treatment of bone tumors☆ ☆ Study carried out at the Pontifícia Universidade Católica de Campinas (PUC-Campinas), Hospital e Maternidade Celso Pierro, Serviço de Ortopedia e Traumatologia, Campinas, SP, Brazil.

ABSTRACT

OBJECTIVES:

METHODS:

RESULTS:

CONCLUSION:

Functional assessment of endoprosthesis in the treatment of bone tumors^☆ ☆ Study carried out at the Pontifícia Universidade Católica de Campinas (PUC-Campinas), Hospital e Maternidade Celso Pierro, Serviço de Ortopedia e Traumatologia, Campinas, SP, Brazil.

Patient	Pain	Function	Emotional acceptance	Supports	Walking	Gait	Strength	ROM
1	3	5	4	6	5	4	6	2
2	6	5	6	2	4	3	6	5
3	–	–	–	–	–	–	–	–
4	4	4	6	1	3	2	4	6
5	–	–	–	–	–	–	–	–
6	6	2	6	2	3	2	6	3
7	6	5	4	6	6	4	6	5
8	6	2	6	1	2	2	6	6
9	–	–	–	–	–	–	–	–
10	4	1	4	6	–	–	0	0
11	4	3	5	1	3	2	6	4
12	5	5	4	6	5	5	6	4
13	4	3	2	3	4	3	6	5
14	3	3	6	6	6	2	6	2