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Clinical Orthopaedics and Related Research®

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01-07-2012 | Clinical Research

Does Limb-salvage Surgery Offer Patients Better Quality of Life and Functional Capacity than Amputation?

Authors: Farbod Malek, MD, Jeremy S. Somerson, MD, Shannon Mitchel, MD, Ronald P. Williams, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2012

Abstract

Introduction

Patients with aggressive lower extremity musculoskeletal tumors may be candidates for either above-knee amputation or limb-salvage surgery. However, the subjective and objective benefits of limb-salvage surgery compared with amputation are not fully clear.

Questions/Purposes

We therefore compared functional status and quality of life for patients treated with above-knee amputation versus limb-salvage surgery.

Methods

We reviewed 20 of 51 patients aged 15 years and older treated with above-knee amputation or limb-salvage surgery for aggressive musculoskeletal tumors around the knee between 1994 and 2004 as a retrospective cohort study. At last followup we obtained the Physiological Cost Index, the Reintegration to Normal Living Index, SF-36, and the Toronto Extremity Salvage Score questionnaires. The minimum followup was 12 months (median, 56 months; range, 12–108 months).

Results

Compared with patients having above-knee amputation, patients undergoing limb-salvage surgery had superior Physiological Cost Index scores and Reintegration to Normal Living Index. The Toronto Extremity Salvage scores and SF-36 scores were similar in the two groups.

Conclusion

These data suggest that limb-salvage surgery offers better gait efficiency and return to normal living compared with above-knee amputation, but does not improve the patient’s perception of quality of life.

Level of Evidence

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Title: Does Limb-salvage Surgery Offer Patients Better Quality of Life and Functional Capacity than Amputation?
Authors: Farbod Malek, MD
Jeremy S. Somerson, MD
Shannon Mitchel, MD
Ronald P. Williams, MD
Publication date: 01-07-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 7/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2271-1

At a glance: The STEP trials

Springer Medicine

Does Limb-salvage Surgery Offer Patients Better Quality of Life and Functional Capacity than Amputation?

Abstract

Introduction

Questions/Purposes

Methods

Results

Conclusion

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Questions/Purposes

Methods

Results

Conclusion

Level of Evidence

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