CORR Insights®: What Sports Activity Levels Are Achieved in Patients With Modular Tumor Endoprostheses of Osteosarcoma About the Knee?

Joyce, Michael

doi:10.1007/s11999-014-3881-6

Cited by 3 publications

(7 citation statements)

References 4 publications

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“…The main goal for treatment of malignant tumors of the extremities is to maximize survival while preserving a functional limb when at all possible. However, recommendations of permanent limits of sports activities to lessen long-term prosthetic failures by reconstructive surgeons are variable from one surgeon to another [ 16 ]. Whereas many patients after elective joint replacement of the hip can still carry out sport activities, some tumor surgeons are reluctant to allow patients with these more complex reconstructions to participate in many athletic activities.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients with femur megaprostheses differ from patients after elective joint replacements because of the use of larger, more complex implants, a more invasive operation with resection of bone and soft tissues, and the generally younger age at implantation compared with patients with hip arthritis. Unfortunately, very few data exist with regard to the sports activity levels of patients with megaprostheses after sarcoma resection [ 15 , 16 , 18 ]. Some patients with sarcoma may want to have information about activity after treatment, but little objective information exists in general [ 22 ] and even less concerning postoperative sport activities in patients who have been treated with a proximal femur megaprosthesis for a malignant bone tumor.…”

Section: Introductionmentioning

confidence: 99%

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What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma?

Hobusch

Bollmann

Puchner

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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BackgroundLimited information is available about sports activities of survivors after resection and reconstruction of primary malignant bone tumors with megaprostheses. Because patients often ask what activities are possible after treatment, objective knowledge about sports activities is needed to help assess the risks of sports participation and to help guide patients’ expectations.Questions/purposesThe aims of this study were to evaluate (1) what proportion of patients with proximal-femoral megaprostheses placed as part of tumor reconstructions can perform sports; (2) what activity levels they achieved; and (3) whether sports activity levels are associated with an increased likelihood of revision.MethodsThis retrospective study considered all 27 living patients in our institutional tumor registry with enduring proximal-femoral reconstructions performed more than 5 years ago who were between the ages of 11 and 49 years at the time of the reconstruction; seven were lost to followup and one was excluded because of paraplegia as a result of a car accident and another because of senile dementia; another two were excluded from statistics because of growing prostheses and skeletal immaturity at the time of followup, leaving 16 (11 male, five female) for analysis. Their mean age was 26 ± 12 years (range, 11–49 years) at surgery, and the mean followup was 18 ± 7 years (range, 5–27 years). Types of sports, frequency per week, duration of each sports session as well as the UCLA and modified Weighted Activity Score were assessed retrospectively by an independent assessor a median of 18 years (range, 5.3–27 years) after surgery.ResultsPatients recalled that preoperatively 14 were practicing sports 5 (± 4) hours/week. At followup, 11 of the patients were practicing one or more sports activities 2 (± 3) hours/week on a regular basis. The preoperative UCLA and modified Weighted Activity Score levels of 9 and 6 fell to levels of 6 (p = 0.005) and 3 (p = 0.025), respectively, at followup. With the numbers of patients available for study, we could not determine that prosthetic failures were associated with sport activity levels.ConclusionsPatients who survive primary malignant bone tumors in the proximal femur reconstructed by megaprostheses are able to perform some sports activities. The estimates of activity levels made in this study probably are best-case estimates, given that some patients were lost to followup; patients unaccounted for might not be doing as well as those represented here. Also, the degree to which sports participation influences implant durability remains, for the most part, unanswered; studies with more patients and longer followup will be needed to determine to what degree prosthesis survivorship relates to sporting activity levels. Most patients perform low-impact sports and at a lower level than they had preoperatively. Because this is a preliminary study of a select group of patients, further information is necessary to weight the benefits of higher sports activity levels against potential risks. If thi...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma?

Hobusch

Bollmann

Puchner

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…Surgical resection is currently the cornerstone of treatment and involves the complete removal of the tumor with substantial volumes of bone, muscle, and other connective tissue loss, leading to long‐term disability including difficulty returning to sports 2,4,5 . The primary goal of surgical treatment is cure by controlling the tumor locally, with the secondary aims of providing the best possible limb function, aesthetics, and quality of life (QOL) 4,6–9 …”

Section: Introductionmentioning

confidence: 99%

“…However, this may be difficult due to the disability associated with sarcoma surgery 15,18,19 . The majority of orthopedic oncological surgeons' caution against sports participation, to protect implants/grafts against complications and allow recovery 4,6,7,15 . However, there is little literature investigating participation in sports and its impact on the surgical construct, 5,7,13,14 and restrictions on physical activity need to be balanced against the benefits of exercise 6 .…”

Section: Introductionmentioning

confidence: 99%

Return to sports following lower limb musculoskeletal tumor surgery—A systematic review

Buldu

Sacchetti

Yasen

et al. 2023

Scandinavian Med Sci Sports

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Background: Survivors of primary malignant musculoskeletal tumors often face long-term disability. Clinicians at present are unable to provide evidence-based advice about returning to sports, which is important for active patients. Purposes:1. Identify patients returning to sports.2. Describe the sporting activities in which patients participate.3. Identify the outcome measures used to assess return to sport. 4. Identify barriers preventing return to sports. Study design: Systematic review. Methods: A comprehensive search strategy was used to identify relevant studies combining the following concepts: (1) Bone/Soft tissue tumor, (2) Lower limb, (3) Surgical interventions, and (4) Sports. Studies were selected according to eligibility criteria with the consensus of three authors (MTB, FS, and CG).Results: Twenty-two studies were selected, published between 1985 and 2020, including 1005 patients. Fifteen of the 22 studies had valid data on return to sports, with 705 participants, of which 412 (58.4%) returned to some form of sport such as swimming and cycling, at a mean follow-up period of 7.6 years. Four studies directly compared limb sparing surgery and amputation; none of these were able to identify a difference in sports participation or ability. Conclusion:There is insufficient published research to provide guidance for patients with respect to return to sports following musculoskeletal tumors. Future prospective studies are needed to collect better pre-and post-treatment data at multiple time intervals. Validated clinical and patient sports participation outcomes such as type of sports, level, frequency, and validated sports-specific outcome scores should be recorded. In particular, more comparison between limb sparing surgery and amputation would be welcome.

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“…There is not a uniform recommendation on whether sporting activity could be allowed after megaprosthetic replacement: while some tumor and adult reconstructive surgeons restrict routine total joint patients from even moderate athletic endeavors, others set the patient-expectations-in-achievement bar quite high [ 12 ]. A survey among orthopedic tumor surgeons, who regularly do lower-extremity bone tumor and megaprosthetic replacement in active younger patients, may help to define limits within sports that may be possible for patients after these kinds of treatment.…”

Section: Introductionmentioning

confidence: 99%

What Opinions Do Tumor Reconstructive Surgeons Have about Sports Activity after Megaprosthetic Replacement in Hip and Knee? Results of the MoReSports Expert Opinion Online Survey

Hobusch

Keusch

Tsuchiya

et al. 2020

JCM

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Sports activity has many benefits in cancer survivors. A key one is having sport activity contribute to the well-being of the individual. However, there are no guidelines about the intensity and kind of postoperative mobility workouts after hip or knee megaprosthetic treatment. Opinion research about sports after modular bone and joint replacement may provide an understanding of surgeons’ attitudes on sports activity after megaprostheses of the hip and knee joint. A web survey with members of three international professional organizations of orthopedic tumor reconstructive surgeons was conducted between September 2016 and January 2018. Members were invited via personalized emails by the European Musculoskeletal Oncology Society (EMSOS), the International Society of Limb Salvage (ISOLS), and the Musculoskeletal Tumor Society (MSTS). The questionnaire included 26 questions. A total of 149 surgeons started the survey, and 76 finished the entire survey (American Association for Public Opinion Research (AAPOR) second response rate (RR2) EMSOS: 12.3%; ISOLS: 21.9%; MSTS: n/a). More than half of the respondents encourage sarcoma survivors after megaprosthetic treatment to reach an activity level that would allow them to regularly participate in active sporting events of University of California, Los Angeles (UCLA) activity level 7 and higher. Orthopedic tumor reconstructive surgeons do fear a number of complications (periprosthetic fracture, allograft failure/fracture, loosening, prosthetic or bearing failure, and early polyethylene wear) due to sports activity after modular bone–joint replacement, but they actually witness fewer complications than they conceptually anticipated. According to the surgeons’ opinions, between four to seven types of sports after surgery could reasonably be recommended depending on the type of hip or knee procedures. This survey provides insights into opinions on what could be recommended, what could be allowed if surgeons and their patients agree on the potential negative outcome, and which sports should definitely not be allowed after hip and knee megaprostheses.

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CORR Insights®: What Sports Activity Levels Are Achieved in Patients With Modular Tumor Endoprostheses of Osteosarcoma About the Knee?

Cited by 3 publications

References 4 publications

What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma?

What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma?

Return to sports following lower limb musculoskeletal tumor surgery—A systematic review

What Opinions Do Tumor Reconstructive Surgeons Have about Sports Activity after Megaprosthetic Replacement in Hip and Knee? Results of the MoReSports Expert Opinion Online Survey

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