Physical function and quality of life in patients with endoprosthesis of the lower extremity after bone sarcoma treatment – a cross-sectional study

Primary malignant bone sarcoma is a rare disease with a five-year survival rate of 55-75%. Increased survival rates have allowed for limb sparing surgery, without compromising survival rate, and a paradigm shift from amputation as the preferred surgical solution toward limb sparing surgery occurred. The disease affects young people who will intent to return to work and normal daily life activities after limb sparing surgery. However, few studies have focused on the post-operative condition and very little is known about health-related outcomes and rehabilitation for this patient group. Basic knowledge about health-related domains is essential for designing future optimal rehabilitation programs. A commonly used, but poorly validated, outcome measure to evaluate physical function in bone sarcoma is the Musculoskeletal Tumor Society score (MSTS).
The study includes the following three purposes:
1. To measure deficits of physical function, identify self-reported difficulties in performing activities and evaluate health-related quality of life in patients with endoprosthesis following primary bone tumors compared to healthy controls.
2. To explore the relationship between health-related outcomes in patients with endoprosthesis following primary bone tumors.
3. To evaluate the clinimetric properties of the MSTS.
A cohort of patients that were treated between 2006-2016 at the University Hospital Rigshospitalet along with healthy volunteers will be asked to participate in this cross-sectional study. To enable mapping out deficits and difficulties in daily life in this patient group, a broad spectra of assessments will be applied (muscle strength, range of motion, pain, activities of daily living, physical activity, quality of life). The data is fundamental for designing future prospective studies. The data will also help clinicians to better inform patients of what to expect in daily life after this type of surgery.

Malignant bone tumor is a rare type of cancer. The treatment of choice is limb-sparing surgery with excision of bone tumor and replacement of bone loss with the use of mega-prostheses. Along with increased survival rates, limb-sparing surgery is a great improvement compared to earlier year’s amputations. However, little is known about activities of daily living and quality of life for this patient group.
With this study, we aim to provide insights into the challenges and restrictions of surviving bone tumor and living with a mega-prosthesis.
Patients operated with a mega-prosthesis of the hip or knee in the period 2006-2016 at University Hospital Rigshospitalet will be invited to participate alongside with healthy, age related volunteers. Study participants will fill in questionnaires, undergo physical evaluation and wear activity tracker for 14 days.
The future perspectives are optimized evaluation and rehabilitation for this patient group based on the evidence generated by this project.

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