Morri Mattia, Forni Cristiana, Ruisi Riccardo, Giamboi Tiziana, Giacomella Fabrizio, Donati Davide Maria, Benedetti Maria Grazia
Servizio di Assistenza Infermieristica, Tecnica e della Riabilitazione, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
Clinica Ortopedica e Traumatologica III a prevalente indirizzo Oncologico, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
BMC Musculoskelet Disord. 2018 Oct 2;19(1):353. doi: 10.1186/s12891-018-2280-7.
The objective of this study is to describe the rehabilitative pathway of patients undergoing endoprosthetic knee replacement surgery, build reference values of the functional results achieved, and identify possible prognostic factors.
Prospective observational study. All patients undergoing resection and knee replacement surgery using a modular prosthesis following bone tumor resection were consecutively recruited over the last 2 years. The patients were followed for a period of 1 year, the result values were collected at 3, 6 and 12 months.
In total, 30 patients were enrolled. The median age was 19 years with 33% of patients being female. Median values recorded for knee flexion, quadriceps strength, Toronto Extremity Salvage Score, Time Up and Go and Six Minutes Walking Test showed an improvement of 16, 25, 18, 48 and 38% from 3 to 12 months, respectively. The level and width of the resection were correlated with the mobility of the knee and the strength of the quadriceps.
Patients undergoing knee replacement for bone tumors were able to achieve satisfactory functional outcomes from the first postoperative year. A specific assessment of outcomes can be conducted to facilitate the management of patient expectations. A very wide resection and interventions of the proximal tibia are risk factors for a poorer functional outcome.
本研究的目的是描述接受人工膝关节置换手术患者的康复途径,建立所取得功能结果的参考值,并确定可能的预后因素。
前瞻性观察研究。在过去2年中,连续招募了所有在骨肿瘤切除术后使用模块化假体进行切除和膝关节置换手术的患者。对患者进行为期1年的随访,在3、6和12个月时收集结果值。
共纳入30例患者。中位年龄为19岁,33%的患者为女性。膝关节屈曲、股四头肌力量、多伦多肢体挽救评分、起立行走测试和6分钟步行测试的中位值显示,从3个月到12个月分别改善了16%、25%、18%、48%和38%。切除的水平和宽度与膝关节的活动度和股四头肌的力量相关。
接受骨肿瘤膝关节置换的患者在术后第一年能够取得满意的功能结果。可以进行特定的结果评估,以促进对患者期望的管理。非常广泛的切除和胫骨近端的干预是功能结果较差的危险因素。