Physical Therapy Department, King Fahad Specialist Hospital, Dammam City, Saudi Arabia.
Portsmouth Enablement Centre, Portsmouth University Hospitals NHS Trust, Portsmouth, UK.
Disabil Rehabil. 2022 Aug;44(16):4531-4545. doi: 10.1080/09638288.2021.1900409. Epub 2021 Mar 23.
Limb salvage surgery is a surgical procedure for tumour resection in bone and soft-tissue cancers. Guidelines aim to preserve as much function and tissue of the limb as possible. Surgical outcome data is routinely available as part of surgical reporting processes. What is less known are important non-oncological outcomes throughout recovery from both clinical and patient perspectives. The objective of this review was to explore non-oncological outcomes in patients diagnosed with sarcoma around the knee following limb salvage surgery.
A scoping review methodology was used, and results analysed using CASP checklists.
Thirteen studies were included and following appraisal and synthesis, three themes emerged as providing important measures intrinsic to successful patient recovery: (1) physical function, (2) quality of life and, (3) gait and knee goniometry. Specifically, patients develop range of motion complications that alter gait patterns and patients often limit their post-operative participation in sport and leisure activities.
This study has shown the importance of exploring confounding factors, adopting a holistic view of patient recovery beyond surgical outcomes, proposing evidence-based guidance to support and inform healthcare providers with clinical decision-making. This review highlights the paucity and lack of quality of research available, emphasising how under-represented this population is in the research literature.IMPLICATIONS FOR REHABILITATIONPatients having undergone LSS often have limited participation in sport and leisure activities.Patients can develop range of motion complications, such as flexion contracture or extension lag, which may affect the pattern of gait.Clinical consideration should be given to walking ability and gait patterns during the rehabilitation phase to prevent poor functional outcomes during recovery.Variation of treatment protocols, outcome measurement and rehabilitative care has been identified as important in predicting the outcomes in recovery from LSS procedures.
保肢手术是一种用于治疗骨和软组织癌症的肿瘤切除术。指南旨在尽可能保留肢体的功能和组织。手术结果数据通常作为手术报告流程的一部分提供。但从临床和患者的角度来看，在康复过程中，哪些是非肿瘤学的重要结果还不太清楚。本综述的目的是探讨膝关节周围保肢手术后诊断为肉瘤的患者的非肿瘤学结果。
采用范围综述方法，使用 CASP 检查表对结果进行分析。
共纳入 13 项研究，经过评估和综合分析，有三个主题出现，为成功患者康复提供了重要的衡量标准：（1）身体功能，（2）生活质量，（3）步态和膝关节测角术。具体来说，患者会出现运动范围的并发症，改变步态模式，并且患者通常会限制他们在术后参与运动和休闲活动。
本研究表明，探索混杂因素、超越手术结果对患者康复进行全面评估、提出循证指导以支持和为临床决策提供信息的重要性。本综述强调了可供研究的缺乏和质量差的问题，突出了这一人群在研究文献中的代表性不足。
接受保肢手术的患者往往限制了他们在运动和休闲活动中的参与。患者可能会出现运动范围的并发症，如屈曲挛缩或伸展滞后，这可能会影响步态模式。在康复阶段应考虑步行能力和步态模式，以防止康复过程中出现不良的功能结果。治疗方案、结果测量和康复护理的变化已被确定为预测保肢手术后恢复结果的重要因素。
