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Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol

Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treat...

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Autores principales: Andreani, Lorenzo, Ipponi, Edoardo, Falcinelli, Federico, Barderi, Sara, Vannucci, Lorenzo, Campo, Francesco Rosario, D’Arienzo, Antonio, Parchi, Paolo Domenico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10671754/
https://www.ncbi.nlm.nih.gov/pubmed/37998476
http://dx.doi.org/10.3390/healthcare11222984
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author Andreani, Lorenzo
Ipponi, Edoardo
Falcinelli, Federico
Barderi, Sara
Vannucci, Lorenzo
Campo, Francesco Rosario
D’Arienzo, Antonio
Parchi, Paolo Domenico
author_facet Andreani, Lorenzo
Ipponi, Edoardo
Falcinelli, Federico
Barderi, Sara
Vannucci, Lorenzo
Campo, Francesco Rosario
D’Arienzo, Antonio
Parchi, Paolo Domenico
author_sort Andreani, Lorenzo
collection PubMed
description Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment is yet to be established. In this study, we report on our experience with our latest standardized rehabilitation program, evaluating our results in a mid-to-long-term scenario. Materials and Methods: We evaluated the functional results of all our oncologic patients treated between 2016 and 2022 who could follow our standardized post-operative rehabilitative approach, consisting of progressive knee mobilization and early weight-bearing. Results: Sixteen cases were included in our study. The average duration of the patients’ hospitalization was 12.2 days. A standing position was reached on average 4.1 days after surgery, while assisted walking was started 4.5 days after surgery. After a mean post-operative follow-up of 46.7 months, our patients’ mean MSTS score was 23.2 (10–30). Our data suggest that the sooner patients could achieve a standing position (R = −0.609; p = 0.012) and start walking (R = −0.623; p = 0.010), the better their final functional outcomes regarding their MSTS scores. Conclusions: Rehabilitation should be considered a pivotal factor in decreeing the success of distal femur megaprosthetic implants in long-surviving oncologic patients. Correct rehabilitation, focused on early mobilization and progressive weight-bearing, is crucial to maximizing the post-operative functional outcomes of these patients.
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spelling pubmed-106717542023-11-19 Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol Andreani, Lorenzo Ipponi, Edoardo Falcinelli, Federico Barderi, Sara Vannucci, Lorenzo Campo, Francesco Rosario D’Arienzo, Antonio Parchi, Paolo Domenico Healthcare (Basel) Article Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment is yet to be established. In this study, we report on our experience with our latest standardized rehabilitation program, evaluating our results in a mid-to-long-term scenario. Materials and Methods: We evaluated the functional results of all our oncologic patients treated between 2016 and 2022 who could follow our standardized post-operative rehabilitative approach, consisting of progressive knee mobilization and early weight-bearing. Results: Sixteen cases were included in our study. The average duration of the patients’ hospitalization was 12.2 days. A standing position was reached on average 4.1 days after surgery, while assisted walking was started 4.5 days after surgery. After a mean post-operative follow-up of 46.7 months, our patients’ mean MSTS score was 23.2 (10–30). Our data suggest that the sooner patients could achieve a standing position (R = −0.609; p = 0.012) and start walking (R = −0.623; p = 0.010), the better their final functional outcomes regarding their MSTS scores. Conclusions: Rehabilitation should be considered a pivotal factor in decreeing the success of distal femur megaprosthetic implants in long-surviving oncologic patients. Correct rehabilitation, focused on early mobilization and progressive weight-bearing, is crucial to maximizing the post-operative functional outcomes of these patients. MDPI 2023-11-19 /pmc/articles/PMC10671754/ /pubmed/37998476 http://dx.doi.org/10.3390/healthcare11222984 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Andreani, Lorenzo
Ipponi, Edoardo
Falcinelli, Federico
Barderi, Sara
Vannucci, Lorenzo
Campo, Francesco Rosario
D’Arienzo, Antonio
Parchi, Paolo Domenico
Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
title Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
title_full Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
title_fullStr Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
title_full_unstemmed Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
title_short Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
title_sort distal femur megaprostheses in orthopedic oncology: evaluation of a standardized post-operative rehabilitation protocol
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10671754/
https://www.ncbi.nlm.nih.gov/pubmed/37998476
http://dx.doi.org/10.3390/healthcare11222984
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