Assessment of Post-operative Physical Performance in Patients after Resection Arthroplasty of the Proximal Femur.

Abstract

Resection arthroplasty is increasingly used in the treatment of proximal femur metastates. How-ever, a coherent, unified rehabilitation protocol of such patients is yet to be developed. The aim of this study was to present the early treatment outcomes of modular endoprosthetic replacement. A total of 42 resections of proximal femur tumour, followed by modular endoprosthetic replacement, were performed at the Orthopaedic Oncology Department in Brzozów between 2012 and 2015. The mean age of the patients was 63 ± 11 years, with females accounting for 54% of the group. All the patients were rehabilitated in accordance with the protocol developed by Shehadeh et al. Pain intensity was measured using the VAS scale, while the HHS, MSTS and an original scale designed by the authors were used to assess overall physical performance and gait efficiency. Thirty GMRS and 12 MUTARS endoprostheses were implanted. The implants were fixed with bone cement in 36 (85%) cases and cementless in 8 (15%). Mean pain severity assessed at 6 weeks after the surgery with the VAS scale was 3.8. Mean gait efficiency and physical performance assessed with the HHS and MSTS scores were 75 and 20 points, respectively. Two patients experienced complications. A total of 39 patients were evaluated post-operatively at 6 weeks after the surgery, of whom 37 (95%) patients could walk efficiently using crutches or with physical assistance of others. Modular arthroplasty performed in patients after metastatic tumour resection allows for early rehabi-li-ta-tion and ambulation which significantly improves their quality of life.