Background: Endoprosthetic knee replacement is often used to preserve joint function in patients with bone tumors of the distal femur or proximal tibia. Recently, because of improved oncologic outcome, surgeons are focusing more on the functional outcome of patients with musculoskeletal tumors. We hypothesized that patients who have undergone endoprosthetic knee replacement are forced to compensate for deficiency in their operated joint during walking. In this study, we investigated differences in gait kinematics, kinetics, and energetics between patients with endoprosthetic knee replacement and healthy subjects.
Methods: We performed gait analysis for 8 patients who underwent endoprosthetic knee replacement after bone tumor resection and 8 matched healthy subjects. Gait kinematics, kinetics, and energetics of patients' ipsilateral and contralateral limbs were compared with those of healthy subjects by using Dunnett's test.
Findings: Compared with healthy subjects, patients showed increased negative joint power around the ipsilateral ankle, greater second peak in the contralateral vertical ground reaction forces, and abnormal hip movement on both sides after initial contact.
Interpretation: Patients tended to compensate for dysfunction of the reconstructed knee by muscles around the ipsilateral ankle and contralateral hip, with increased load on the contralateral limb during walking. These differences could lead to secondary impairments. Further analysis, including musculoskeletal simulation and assessment of long-term functional outcome with regard to secondary musculoskeletal impairment, is needed to verify the significance of the change in gait and to determine the need for special care for secondary musculoskeletal dysfunction in these patients.
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http://dx.doi.org/10.1016/j.clinbiomech.2013.08.005 | DOI Listing |
World J Surg Oncol
December 2024
Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.
Background: Endoprosthetic knee replacement using megaprostheses has become a common strategy for preserving joint function in patients with distal femur tumors. While existing literature has primarily focused on surgical techniques, complications, and implants, recent improvements in patient survival rates have sparked increased interest in the long-term functional outcomes associated with this treatment.
Methods: This case-control study evaluated functional outcomes-Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), knee flexor and extensor muscle strength, and sagittal knee range of motion-and health-related quality of life (SF-36) between patients with distal femoral megaprostheses (n = 31) and healthy controls (n = 48).
Medicina (Kaunas)
November 2024
Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany.
: The experience of unpleasant sensory phenomena after lower limb amputations (LLAs), including phantom limb pain (PLP), phantom limb sensation (PLS), and residual limb pain (RLP), impacts global healthcare and adversely affects outcomes post-amputation. This study aimed to describe the distribution of PLP, PLS, and RLP among patients with LLAs registered in the Heidelberg Amputation Registry. The primary objective was to determine the prevalence of sensory abnormalities across different amputation levels and causes.
View Article and Find Full Text PDFSkeletal Radiol
November 2024
Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Cureus
September 2024
Orthopaedics, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Bone Joint J
October 2024
Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Aims: Periprosthetic joint infection (PJI) is a challenging complication of any arthroplasty procedure. We reviewed our use of static antibiotic-loaded cement spacers (ABLCSs) for staged management of PJI where segmental bone loss, ligamentous instability, or soft-tissue defects necessitate a static construct. We reviewed factors contributing to their failure and techniques to avoid these complications when using ABLCSs in this context.
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