Background

With survival rates being same in the limb salvage and limb amputee groups, endoprosthetic reconstruction is becoming treatment of choice for osteosarcoma patients. We studied the functional outcomes at one year follow-up in the limb salvage (endoprosthetic reconstruction) and limb amputee patients.

Methods

A total of 45 patients were enrolled in the study according to the inclusion criteria. Patients with tumour resection and endoprosthetic reconstruction were included in group 1 and patients with amputation in group 2. The functional outcomes were evaluated by means of Toronto Extremity Salvage Scoring System (TESS), Short Form-36 (SF-36) Questionnaire and Musculoskeletal Tumour Society Score (MSTS).

Results

The mean age of patients in group 1 and 2 were 17.04 ± 13.74 and 18.38 ±5.37 years respectively (p=0.73). There were a total of 22 males and 5 females in group 1 and 16 males and 2 females in group 2 (p=0.38). Distal femur and proximal tibia were the most common site of involvement in both the groups (p=0.21). The mean follow-up of patients in group 1 and group 2 were 28.34±16.06 and 32.41±20.04 months respectively. A total of 20 patients in group 1 and 13 patients in group 2 had tumour volume of <200cm3 (p=0.41). There were 4 cases of distant metastasis, two in each group (p=0.26). There were a total of 7 complications, 4 in group 1 and 3 in group 2 (p=0.63). The mean MSTS score was found to be 25.40±4.29 (81.60%) in group 1. The mean TESS scores in group 1 and group 2 were 80.60±12.36 and 58.50±21.21 respectively (p<0.05). Post-surgical mean SF-36 score was significant in group 1.

Conclusion

Satisfactory functional outcomes with improved quality of life were observed in patients who underwent endoprosthetic reconstruction compared to the limb amputee group.