Long-term functional outcome and quality of life following rotationplasty for treatment of malignant tumors
Tóm tắt
Malignant bone tumors of the lower extremity are more frequently found in children and adolescents than in adults. Modern treatment regimens led to high limb salvage rates and offer the choice between endoprosthetic replacement and rotationplasty in many cases. Rotationplasty has proven to be an effective, highly functional option in short- and mid-term studies. Aim of this study was to assess long-term results regarding quality of life and functionality after rotationplasty and to compare the obtained results to a representative healthy German sample cohort. In total 12 patients who underwent rotationplasty between 1991 and 2001 were enrolled in this study. After physical examination, they were evaluated regarding health related quality of life, functional outcome and psychosocial status. While quality of life was mainly assessed using the SF-36 (The Short Form (36) Health Survey v2), functional outcome was measured using the musculoskeletal tumor society score (MSTS) as well as the Tegner activity level scale. Average age at the time of surgery was 19 ± 10 year. and 32 ± 11 year. at the time of follow up. Mean follow-up was 14 ± 9 years. The SF-36 scores accounted for 80.4 ± 15.7 regarding physical functioning, for 78.1 ± 24.1 regarding the physical role functioning, for 74.1 ± 17.6 regarding bodily pain and for 71.8 ± 26.1 regarding general health. SF-36 score for vitality was 75.0 ± 12.8, for social functioning 98.9 ± 3.6, 88.2 ± 23.9 for emotional role functioning and 89.6 ± 10.1 for the mental health. Comparison to a representative German sample cohort revealed significantly higher patient’s scores for vitality, social functioning and mental health (p < 0.05). The overall MSTS resulted in an average of 64 ± 12 % and the Tegner activity level scale accounted for 4.1 ± 0.6 pts. The presented long-term results indicate that rotationplasty provides a high quality of life. Patients are satisfied with a good functional outcome regarding activities of daily life and even sports.
Tài liệu tham khảo
Grimer R, Judson I, Peake D, Seddon B. Guidelines for the management of soft tissue sarcomas. Sarcoma. 2010;2010:506182.
von Eisenhart-Rothe R, Toepfer A, Salzmann M, Schauwecker J, Gollwitzer H, Rechl H. [Primary malignant bone tumors]. Orthopade. 2011;40(12):1121–42.
Andreou D, Hardes J, Gosheger G, Henrichs MP, Nottrott M, Streitburger A. [Interdisciplinary diagnostic and treatment of bone sarcomas of the extremities and trunk]. Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse. 2015;47(2):90–9.
Wilkins RM, Cullen JW, Odom L, Jamroz BA, Cullen PM, Fink K, et al. Superior survival in treatment of primary nonmetastatic pediatric osteosarcoma of the extremity. Ann Surg Oncol. 2003;10(5):498–507.
Papagelopoulos PJ, Mavrogenis AF, Mastorakos DP, Patapis P, Soucacos PN. Current concepts for management of soft tissue sarcomas of the extremities. J Surg Orthop Adv. 2008;17(3):204–15.
Bacci G, Ferrari S, Bertoni F, Ruggieri P, Picci P, Longhi A, et al. Long-term outcome for patients with nonmetastatic osteosarcoma of the extremity treated at the istituto ortopedico rizzoli according to the istituto ortopedico rizzoli/osteosarcoma-2 protocol: an updated report. J Clin Oncol Off J Am Soc Clin Oncol. 2000;18(24):4016–27.
Ferrari S, Smeland S, Mercuri M, Bertoni F, Longhi A, Ruggieri P, et al. Neoadjuvant chemotherapy with high-dose Ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: a joint study by the Italian and Scandinavian Sarcoma Groups. J Clin Oncol. 2005;23(34):8845–52.
Grimer RJ. Surgical options for children with osteosarcoma. Lancet Oncol. 2005;6(2):85–92.
Ayerza MA, Farfalli GL, Aponte-Tinao L, Muscolo DL. Does increased rate of limb-sparing surgery affect survival in osteosarcoma? Clin Orthop Relat Res. 2010;468(11):2854–9.
Rougraff BT, Simon MA, Kneisl JS, Greenberg DB, Mankin HJ. Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study. J Bone Joint Surg Am Vol. 1994;76(5):649–56.
Mizuno N, Aoyama T, Nakajima A, Kasahara T, Takami K. Functional evaluation by gait analysis of various ankle-foot assemblies used by below-knee amputees. Prosthetics Orthot Int. 1992;16(3):174–82.
Otis JC, Lane JM, Kroll MA. Energy cost during gait in osteosarcoma patients after resection and knee replacement and after above-the-knee amputation. J Bone Joint Surg Am Vol. 1985;67(4):606–11.
Cammisa Jr FP, Glasser DB, Otis JC, Kroll MA, Lane JM, Healey JH. The Van Nes tibial rotationplasty. A functionally viable reconstructive procedure in children who have a tumor of the distal end of the femur. J Bone Joint Surg Am Vol. 1990;72(10):1541–7.
Hillmann A, Hoffmann C, Gosheger G, Krakau H, Winkelmann W. Malignant tumor of the distal part of the femur or the proximal part of the tibia: endoprosthetic replacement or rotationplasty. Functional outcome and quality-of-life measurements. J Bone Joint Surg Am. 1999;81(4):462–8.
Hopyan S, Tan JW, Graham HK, Torode IP. Function and upright time following limb salvage, amputation, and rotationplasty for pediatric sarcoma of bone. J Pediatr Orthop. 2006;26(3):405–8.
Jacobs PA. Limb salvage and rotationplasty for osteosarcoma in children. Clin Orthop Relat Res. 1984;188:217–22.
Kotz R, Salzer M. Rotation-plasty for childhood osteosarcoma of the distal part of the femur. J Bone Joint Surg Am Vol. 1982;64(7):959–69.
Health related quality of life in adolescent and young adult survivors of lower extremity bone tumors. Barrera M, Teall T, Barr R, Silva M, Greenberg M. Pediatr Blood Cancer. 2012;58(2):265-73. doi: 10.1002/pbc.23017. Epub 2011 Feb 11.
Rotationplasty (Borggreve/Van Nes and modifications) as an alternative to amputation in failed reconstructions after resection of tumours around the knee joint. Ramseier LE, Dumont CE, Exner GU. Scand J Plast Reconstr Surg Hand Surg. 2008;42(4):199-201.
Hanlon M, Krajbich JI. Rotationplasty in skeletally immature patients. Long-term followup results. Clin Orthop Relat Res. 1999;358:75–82.
Morfeld M, Bullinger M, Nantke J, Brahler E. The version 2.0 of the SF-36 Health Survey: results of a population-representative study. Soz Praventivmed. 2005;50(5):292–300.
Ware JE, Jr, Kosinski, M., Bjorner, J. B., Turner-Bowker, D. M., Gandek, B., & Maruish, M. E.: User’s manual for the SF-36v2™ health survey (2nd ed.). Lincoln 2007(RI: QualityMetric Incorporated).
Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat R. 1993;286:241–6.
Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–9.
Return to play following ACL reconstruction: survey among experienced arthroscopic surgeons (AGA instructors). Petersen W, Zantop T. Arch Orthop Trauma Surg. 2013;133(7):969-77. doi: 10.1007/s00402-013-1746-1.
Bielack S, Jurgens H, Jundt G, Kevric M, Kuhne T, Reichardt P, et al. Osteosarcoma: the COSS experience. Cancer Treat Res. 2009;152:289–308.
Winkelmann WW. Rotationplasty. Orthop Clin N Am. 1996;27(3):503–23.
Gebert C, Hardes J, Vieth V, Hillmann A, Winkelmann W, Gosheger G. The effect of rotationplasty on the ankle joint: long-term results. Prosthetics Orthot Int. 2006;30(3):316–23.
Bernthal NM, Monument MJ, Randall RL, Jones KB. Rotationplasty: beauty is in the Eye of the beholder. Oper Tech Orthop. 2014;24(2):103–10.
Harris JD, Trinh TQ, Scharschmidt TJ, Mayerson JL. Exceptional functional recovery and return to high-impact sports after Van Nes rotationplasty. Orthopedics. 2013;36(1):e126–31.
So NF, Andrews KL, Anderson K, Gozola MA, Shives TC, Rose PS, et al. Prosthetic fitting after rotationplasty of the knee. Am J Phys Med Rehabil. 2014;93(4):328–34.
Veenstra KM, Sprangers MAG, Van der Eyken JW, Taminiau AHM. Quality of life in survivors with a Van Ness-Borggreve rotationplasty after bone tumour resection. J Surg Oncol. 2000;73(4):192–7.
Rodl RW, Pohlmann U, Gosheger G, Lindner NJ, Winkelmann W. Rotationplasty - quality of life after 10 years in 22 patients. Acta Orthop Scand. 2002;73(1):85–8.
Henderson E, Pepper A, Marulanda G, Millard J, Letson GD. What is the emotional acceptance after limb salvage with an expandable prosthesis? Clin Orthop Relat Res. 2010;468(11):2933–8.
Jiao-Mei X, Wen G, Feng-Lin C. Quality of life among breast cancer survivors 2 years after diagnosis: the relationship with adverse childhood events and posttraumatic growth. Cancer Nurs. 2015 [Epub ahead of print].
Sears SR, Stanton AL, Danoff-Burg S. The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychol. 2003;22(5):487–97.
Kreshak JL, Fabbri N, Manfrini M, Gebhardt M, Mercuri M. Rotationplasty for sarcomas of the distal femur: long-term survival, function and quality of life. J Bone Joint Surgery Br Vol. 2012;94-B(143).
Shehadeh A, Noveau J, Malawer M, Henshaw R. Late complications and survival of endoprosthetic reconstruction after resection of bone tumors. Clin Orthop Relat Res. 2010;468(11):2885–95.
Warrener T, El-Dalil P, Abudu A, MDe S. A comparative study of complications and functional outcomes of endoprosthetic replacement and rotationplasty in childhood. J Bone Joint Surg Br Vol. 2011;93-B:75.
Tunn PU, Pomraenke D, Goerling U, Hohenberger P. Functional outcome after endoprosthetic limb-salvage therapy of primary bone tumours - a comparative analysis using the MSTS score, the TESS and the RNL index. Int Orthop. 2008;32(5):619–25.
Henderson ER, Pepper AM, Marulanda G, Binitie OT, Cheong D, Letson GD. Outcome of lower-limb preservation with an expandable endoprosthesis after bone tumor resection in children. J Bone Joint Surgery Am Vol. 2012;94A(6):537–47.
Ascherl R. Infektionsmanagement bei Megaimplantaten. Orthopade. 2010;39(10):980–93.
Hillmann A, Weist R, Fromme A, Volker K, Rosenbaum D. Sports activities and endurance capacity of bone tumor patients after rotationplasty. Arch Phys Med Rehabil. 2007;88(7):885–90.
Kreshak JL, Fabbri N, Manfrini M, Gebhardt M, Mercuri M. Rotationplasty for sarcomas of the distal femur: long-term survival, function and quality of life. J Bone Joint Surg Br Vol. 2012;94-B(SUPP XXXVIII):143.
Aksnes LH, Bauer HCF, Jebsen NL, Folleras G, Allert C, Haugen GS, et al. Limb-sparing surgery preserves more function than amputation - a Scandinavian sarcoma group study of 118 patients. J Bone Joint Surg Br Vol. 2008;90B(6):786–94.
DiCaprio MR, Friedlaender GE. Malignant bone tumors: limb sparing versus amputation. J Am Acad Orthop Surg. 2003;11(1):25–37.