Abstract
Background
We compared the differences of Joint-preservation Limb Salvage (JPLS) and Joint-prosthesis Replacement Surgery (JPRS) on limb function and quality of life in patients with osteosarcoma in the knee.
Methods
This retrospective study evaluated the postoperative outcomes of patients treated with JPLS and JPRS for osteosarcoma around the knee between November 2000 and January 2019. All patients were followed up at 1 year postoperatively. Patients' lower extremity function, knee function, and quality of life were evaluated during follow-up using the MSTS score, IKDC score, and SF-36 score.
Results
The patients were divided into two groups: the joint-preservation group (16) and the prosthetic-replacement group (19). All 35 patients received a successful operation, and all incisions healed in one stage after surgery. At 12 months after the operation, the median MTST score in the joint-preservation group was 27(range 24 to30), higher than 24(range 13 to 30) in the prosthetic-replacement group (P < 0.05, Table 2). The median IKDC score in the joint-preservation group was 82.5(range 53 to 95), higher than the 60(range 41 to 80) in the prosthetic- replacement group (P < 0.05, Table 2). The SF-36 scores of physiological and social functions were higher in the joint-preserving group than those in the prosthetic-replacement group (P < 0.05), and there were no significant differences between the groups in the other indexes (P > 0.05). Comparing the distribution of each item in the MSTS and IKDC scoring criteria between the joint-preservation and the prosthetic-replacement group revealed that the limb function, pain, satisfaction, support assistance, and the walking and gait of the joint-preservation group were superior to those of the prosthetic-replacement group (P < 0.05). There was no significant difference in knee flexion between the two groups (P > 0.05). However, the joint-preservation group performed superior to the prosthesis-replacement group in terms of pain, swelling, twisting, softening of the leg, movement downstairs, sitting up from a chair, kneeling, squatting, running straight, jumping up with the injured leg and landing, and quickly stopping or starting (P < 0.05).
Conclusion
Compared with joint-prosthesis replacement surgery, joint-preservation limb salvage performed better joint function and quality of life. The findings provide a signal of superiority for JPLS to JPRS but further investigation is warranted in multicentre trials.
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