Work status after distal femoral Kotz reconstruction for malignant tumors of bone

Abstract

Brown A, Parsons JA, Martino C, Griffin A, Bell RS, Wunder JS, Davis AM. Work status after distal femoral Kotz reconstruction for malignant tumors of bone. Arch Phys Med Rehabil 2003;84:62-8. Objective: To determine the proportion of patients who experienced altered work status after reconstruction with a modular tumor prosthesis and adjuvant chemotherapy for primary sarcoma of the distal femur. Design: We reviewed an institution's tumor database and patients' charts. Disability and work status data were collected preoperatively, at 1 year and 2 years postoperatively and at final follow-up. Setting: Acute-care teaching hospital in Ontario, Canada. Participants: Thirty-six eligible patients. Interventions: Not applicable. Main Outcome Measures: Work status was plotted over time to identify unexpected deviations (based on age and preoperative status), and subjects were assigned to altered work status (defined by detrimental changes in productivity, eg, change from full-time work to not working) or expected work status (defined by ongoing work or students progressing to higher education). Disability was measured with the Toronto Extremity Salvage Score and the Musculoskeletal Tumor Society score. Results: Nine patients (25%) experienced altered work status. There were no significant differences in disability ratings or demographic information between the 2 groups. Baseline job demand and living environment (rural vs urban, P=.001) were predictive by logistic regression. Conclusions: Patients with physically demanding jobs, and those living rurally, are at greatest risk for altered work status. [copy ] 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation