scholarly journals Comparative observation of two types of limb salvage surgery on limb function and quality of life in patients with knee joint osteosarcoma

2021 ◽  
Author(s):  
Zi-Wei Hou ◽  
Wen-Zhe Bai ◽  
Ming Xu ◽  
Kai Zheng ◽  
XiuChun Yu

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.

2020 ◽  
Author(s):  
Zi-Wei Hou ◽  
Wen-Zhe Bai ◽  
Ming Xu ◽  
Kai Zheng ◽  
Xiuchun Yu

Abstract BackgroundWe compared the effects of two surgical procedures on limb function and quality of life in patients with osteosarcoma in the knee.MethodsThis retrospective study evaluated the postoperative outcomes of patients treated with JPLS and JPRS for osteosarcoma around the knee between November 2000 and December 2019. All patients were followed up for at least one year. 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.ResultsAll 38 patients received a successful operation, and all incisions healed in one stage after surgery. At 12 months after the operation, the MSTS score in the prosthetic-replacement group (22.79±5.22) was lower than that in the joint-preservation group (27.05±1.62)(P=0.002). The IKDC score was lower in the prosthetic-replacement group (59.89±11.22) than in the joint-preservation group (76.84±9.42)( P <0.001). After 12 months, the SF-36 scores of physiological and social function in the joint-preserving group were higher than those in the prosthetic-replacement group (P <0.05), and there were no significant differences among 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 was 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 forward, jumping up with the injured leg and landing, and quickly stopping or starting (P < 0.05).ConclusionCompared with joint-prosthesis replacement surgery, joint-preservation limb salvage leads to better joint function and quality of life. To improve the limb function and quality of life of patients with long-term survival osteosarcoma, joint-preservation limb salvage should be carried out according to the principles of Operation Indication, neoadjuvant and effective chemotherapy.


2019 ◽  
Vol 13 (2) ◽  
pp. 166-171
Author(s):  
Rafael Bispo de Souza ◽  
Antônio Carlos Faloni Nunes Pereira ◽  
Rafael Costa Nerys ◽  
Jefferson Soares Martins ◽  
Edegmar Nunes Costa

Objective: To evaluate the limb function and quality of life of patients with posttraumatic fixed equinus deformity treated at a tertiary hospital after arthrodesis with the Ilizarov external fixator. Methods: A study was conducted from January 2015 to June 2018 in which 6 patients were evaluated at outpatient follow-up in the late postoperative period. First, an identification questionnaire was administered to assess limb function using the American Orthopedic Foot and Ankle Society (AOFAS) scale, and quality of life was assessed using the SF-36 questionnaire. Results: A total of 66.6% of the sample had an AOFAS score below 70 (mean total = 57.5), which is considered poor. The mean SF-36 score was low (below 60) in all domains evaluated. The pain domain had the highest score (mean = 57.2). Conclusions: Even after surgery to correct the deformity, patients had impaired function and quality of life. Level of Evidence IV; Therapeutic Studies; Case Series.


2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Nik Alyani Nik Abdul Adel ◽  
Mohd Shukrimi bin Awang ◽  
Zamzuri bin Zakaria

Introduction: Anterior cruciate ligament (ACL) reconstruction has evolved during past decade. All inside technique is introduced aiming for less invasive procedure, bone stock preservation, preservation of tendon at its donor site, better graft positioning and fixation technique. This study is conducted to compare the outcomes of this new technique to the previous biotransfix screw. Materials and method: A cross sectional study was conducted in patients with ACL injury treated with ACL reconstruction surgery in Hospital Sultanah Nur Zahirah, Kuala Terengganu and Hospital Kemaman, Terengganu. Functional outcome with International Knee Documentation Committee (IKDC) score, SF-36 quality of life score and time taken to return to normal activities were evaluated at 18 to 24 months post-operative. Results: Forty patient were recruited, 20 in each group. Of this, 37 were male with age of 25±6.48 years old. 25 were office worker and the rest were field worker. 37.5% were smoker. Patients in biotransfix screw technique operated at 21.3±12.6 months after the injury while those in all inside technique at 17.7±11.9 months(p-value 0.35). BMI was 24.58±4.59. The SF-36 score were similar in both groups with p-value 0.59. Both groups have same IKDC score of 82.99±12.55. Time taken to return to normal activity level was 46.3±19.7 weeks which was similar in both groups(p-value 0.943). Re rupture rate were 10% in biotransfix screw technique and 5% in all inside technique. None of them has any form of infection. There were no correlation between quality of life SF-36 score with age, tobacco use, BMI, duration of injury until operation and occupation of the patient in both techniques. Conclusion: The functional outcome, quality of life and time return to normal activity were similar between patients who had biotransfix screw and all inside technique. There were also no correlations between factors studied with quality of life in both groups.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 19501-19501
Author(s):  
M. Aono ◽  
I. Kudawara ◽  
K. Ohzono ◽  
Y. Aoki ◽  
A. Matsumine ◽  
...  

19501 Background: There are several options for the surgical management of osteosarcoma (OS) especially in the skeletally immature patients. We evaluate the clinical results and quality of life (QOL) of OS patients with limb salvage operations. Methods: From 1996 to 2005, ten children with newly diagnosed previously untreated nonmetastatic (stage IIB) OS of extremities were reviewed. There were 5 females and 5 males. The median age was 12 years (range, 8 to 14). Tumor locations: proximal humerus in 2, proximal femur in 1, distal femur in 2, proximal tibia in 3, distal tibia in 1, and tibial shaft in 1. Patients received neoadjuvant and adjuvant chemotherapy, and local wide resection of tumor. Limb salvage procedures: intraoperative extracorporeal autogenous irradiated bone graft (IORBG) in 4 and prosthetic replacement in 6. The functional results were measured for the patients accordance with the Musculoskeletal Tumor Society rating score. Results: With a median follow up of 4 years (range, 1 to 9), 7 were continuously disease free, 2 died of disease and in one there was no evidence of disease. No local recurrence was seen. Mean functional rating scores of patients with IORBG and prosthetic replacement were 82% (range 77 to 90) and 82% (range 57 to 93), respectively. Functional results were not different between these study groups and relatively good. There was one infection in patients with prosthetic replacement. There were subchondral collapse in 2 (50%), fracture in 1 (25%) and infection in 1 (25%) with IORBG. Conclusions: Limb salvage operation with neoadjuvant chemotherapy is the optimum treatment. However there remain several problems of function after limb salvage operations, with improvement of survival of pediatric osteosarcoma patient. We should select the most suitable surgical procedure to achieve the good function of limbs as well as local control. No significant financial relationships to disclose.


2004 ◽  
Vol 171 (4S) ◽  
pp. 15-16
Author(s):  
Tatsuaki Yoneda ◽  
Shin Imai ◽  
Shinji Urakami ◽  
Hirofumi Kishi ◽  
Kazushi Shigeno ◽  
...  

Author(s):  
A. Babirad

Cerebrovascular diseases are a problem of the world today, and according to the forecast, the problem of the near future arises. The main risk factors for the development of ischemic disorders of the cerebral circulation include oblique and aging, arterial hypertension, smoking, diabetes mellitus and heart disease. An effective strategy for the prevention of cerebrovascular events is based on the implementation of large-scale risk control measures, including the use of antiagregant and anticoagulant therapy, invasive interventions such as atheromectomy, angioplasty and stenting. In this connection, the efforts of neurologists, cardiologists, angiosurgery, endocrinologists and other specialists are the basis for achieving an acceptable clinical outcome. A review of the SF-36 method for assessing the quality of life in patients with the effects of transient ischemic stroke is presented. The assessment of quality of life is recognized in world medical practice and research, an indicator that is also used to assess the quality of the health system and in general sociological research.


2020 ◽  
pp. 33-38
Author(s):  
E. Yu. Gan ◽  
L. P. Evstigneeva

Purpose of the study. Assessing the association between the life quality of patients with Sjogren’s Disease and ongoing therapy with various disease-modifying antirheumatic drugs.Material and methods. The study was conducted on the basis of the regional rheumatology center of the consultative diagnostic clinic of the Sverdlovsk Regional Clinical Hospital No. 1. This work is based on the results of a simultaneous study of 74 patients with primary Sjogren’s Disease (SD), distributed in three comparison groups receiving various disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine. The diagnosis of SD was carried out according to European-American criteria AECGC (2002) [18]. In order to analyze the quality of life of patients with SD, the 36-Item Short Form Health Survey (SF‑36) was used. Statistical data processing was carried out using Statistica 7.0 program.Results. Assessment of the quality of life of patients with SD, which is an integrative criterion of human health and well-being, revealed the absence of statistically significant differences (p > 0.05) on eight scales and two health components of the SF‑36 questionnaire in the analyzed groups that differ in the treatment of disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine.Conclusions. The obtained data indicate an equivalent quality of life in SD patients treated with different disease-modifying antirheumatic drugs methotrexate, chlorambucil and hydroxychloroquine, and therefore hydroxychloroquine can be considered as an alternative basic therapy in patients with SD with certain limitations and contraindications methotrexate and chlorambucil.


Author(s):  
Eldhose Varghese ◽  
Irrin Poulose ◽  
Chaitanya Sagar G ◽  
Jennifer Ann Jose ◽  
Mintu Mathew Ms

Tuberculosis (TB) is potentially airborne severe infectious disease which requires long term treatment. It considerably affects the physical and mental health quality of the patient’s life. Appropriate patient counselling with the help of Patient Information Leaflet will help to improve the patient’s quality of life and overall treatment outcome. To enhance the health related quality of life in pulmonary tuberculosis patients by providing patient counselling with the aid of patient information leaflet. An interventional study was carried out for six months in 80 patients diagnosed with pulmonary tuberculosis from the OP & IP of Tuberculosis and Chest Department of a medical college hospital. The HRQoL was assessed using the SF-36 questionnaire. Appropriate patient counselling was provided with the help of Patient Information Leaflet. In our study, a total of 80 patients were enrolled, out of which 49[61%] were Out-patients, and 31[39%] were In-patients. All the 8 sub domains of the SF-36 survey show statistical significance with improvement in 2nd Visit (after counselling) when compared with the baseline visit. The demographic variables like smoking, low socioeconomic status, allergies, family history show statistically significant association with overall HRQoL. The HRQOL of the pulmonary tuberculosis patients were initially low before the start of Anti-TB therapy, after providing proper patient counselling using patient information leaflet the HRQoL scores were found to be increased on the subsequent re-visits, which implies the need of proper patient counselling and follow-up in PTB for the better quality of life.


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