J Korean Bone Joint Tumor Soc.  2012 Dec;18(2):51-58. 10.5292/jkbjts.2012.18.2.51.

Utility of Gait Analysis and Functional Assessment of Prosthetic Reconstruction in Bone Tumor around the Knee

Affiliations
  • 1Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, Korea. stjung@chonnam.ac.kr

Abstract

PURPOSE
This study attempts to know functional results and gait analysis usefulness in patients with bone tumor around knee joint tumors who underwent prosthesis knee joint reconstruction.
MATERIALS AND METHODS
Retrospective study was conducted with 7 patients out of 30 patients who underwent prosthesis knee joint reconstruction after wide marginal excision for bone tumor around knee in orthopedics of this hospital from 2001 to 2010. Functional assesment and gait analysis were perforemed.
RESULTS
For the SF-36 score, while 'role physical' and 'role emotional' items showed 100% (100 points) high scores individually, general health, physical function, vitality, and social function showed low scores. The mean score of MSTS was 88.1% (23.8 points [17-27]), indicating a relatively high score. For the gait analysis, mean gait velocity was 97.2 m/s, mean cadence was 105.6 step/min, mean stride length was 111.3 m, mean step length was 61.5 cm, swing phase was 39.8%cycle, stance phase was 60.1%cycle, mean single limb support was 37.1%cycle, mean double limb support was 13.0%cycle, and mean push off was 60.7%cycle.
CONCLUSION
It is expected that prosthesis reconstruction after wide marginal excision for bone tumor around knee has relatively good functional results. Gait analysis was considered one of method which showed gait phase and assessed functional ability objectively by quantitative assessment post operative patient condition. It might help treatment and post operative rehabilitation planning with the fuctional assessment.

Keyword

gait analysis; functional assessment; prosthesis; knee joint tumor

MeSH Terms

Equidae
Extremities
Gait
Humans
Knee
Knee Joint
Orthopedics
Prostheses and Implants
Retrospective Studies

Figure

  • Figure 1 Gait analysis of the patient with peroneal nerve injury. We can notice the recovery of ROM and decreased moment of joint of involved leg.


Reference

1. Beebe K, Song KJ, Ross E, Tuy B, Patterson F, Benevenia J. Functional outcomes after limb-salvage surgery and endoprosthetic reconstruction with an expandable prosthesis: a report of 4 cases. Arch Phys Med Rehabil. 2009. 90:1039–1047.
2. Rompen JC, Ham SJ, Halbertsma JP, van Horn JR. Gait and function in patients with a femoral endoprosthesis after tumor resection: 18 patients evaluated 12 years after surgery. Acta Orthop Scand. 2002. 73:439–446.
3. Campanacci M, Costa P. Total resection of distal femur or proximal tibia for bone tumours. Autogenous bone grafts and arthrodesis in twenty-six cases. J Bone Joint Surg Br. 1979. 61-b:455–463.
4. Enneking WF, Shirley PD. Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. J Bone Joint Surg Am. 1977. 59:223–236.
5. Kawai A, Backus SI, Otis JC, Healey JH. Interrelationships of clinical outcome, length of resection, and energy cost of walking after prosthetic knee replacement following resection of a malignant tumor of the distal aspect of the femur. J Bone Joint Surg Am. 1998. 80:822–831.
6. Schindler OS, Cannon SR, Briggs TW, Blunn GW, Grimer RJ, Walker PS. Use of extendable total femoral replacements in children with malignant bone tumors. Clin Orthop Relat Res. 1998. (357):157–170.
7. Ward WG, Dorey F, Eckardt JJ. Total femoral endoprosthetic reconstruction. Clin Orthop Relat Res. 1995. (316):195–206.
8. Gosheger G, Hillmann A, Lindner N, Rödl R, Hoffmann C, Bürger H, Winkelmann W. Soft tissue reconstruction of megaprostheses using a trevira tube. Clin Orthop Relat Res. 2001. (393):264–271.
9. Bielack SS, Kempf-Bielack B, Delling G, et al. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol. 2002. 20:776–790.
10. Ruggieri P, Bosco G, Pala E, Errani C, Mercuri M. Local recurrence, survival and function after total femur resection and megaprosthetic reconstruction for bone sarcomas. Clin Orthop Relat Res. 2010. 468:2860–2866.
11. Skaliczki G, Antal I, Kiss J, Szalay K, Skaliczki J, Szendroi M. Functional outcome and life quality after endoprosthetic reconstruction following malignant tumours around the knee. Int Orthop. 2005. 29:174–178.
12. Donati D, Colangeli M, Colangeli S, Di Bella C, Mercuri M. Allograft-prosthetic composite in the proximal tibia after bone tumor resection. Clin Orthop Relat Res. 2008. 466:459–465.
13. Jeon DG, Kawai A, Boland P, Healey JH. Algorithm for the surgical treatment of malignant lesions of the proximal tibia. Clin Orthop Relat Res. 1999. (358):15–26.
14. Davis AM, Wright JG, Williams JI, Bombardier C, Griffin A, Bell RS. Development of a measure of physical function for patients with bone and soft tissue sarcoma. Qual Life Res. 1996. 5:508–516.
15. Enneking WF. Enneking WF, editor. Modification of the system for funtional evaluation of surgical management of musculoskeletal tumors. Limb Salvage in Musculoskeletal Oncology. 1987. New York: Churchill Livingstone;626–639.
16. Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993. (286):241–246.
17. Brazier JE, Harper R, Jones NM, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992. 305:160–164.
18. McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994. 32:40–66.
19. Otis JC, Lane JM, Kroll MA. Energy cost during gait in osteosarcoma patients after resection and knee replacement and after above-the-knee amputation. J Bone Joint Surg Am. 1985. 67:606–611.
20. Schutte LM, Narayanan U, Stout JL, Selber P, Gage JR, Schwartz MH. An index for quantifying deviations from normal gait. Gait Posture. 2000. 11:25–31.
21. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980. (153):106–120.
22. McClenaghan BA, Krajbich JI, Pirone AM, Koheil R, Longmuir P. Comparative assessment of gait after limb-salvage procedures. J Bone Joint Surg Am. 1989. 71:1178–1182.
23. Harris IE, Leff AR, Gitelis S, Simon MA. Function after amputation, arthrodesis, or arthroplasty for tumors about the knee. J Bone Joint Surg Am. 1990. 72:1477–1485.
Full Text Links
  • JKBJTS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr