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Functional outcome after endoprosthetic limb-salvage therapy of primary bone tumours—a comparative analysis using the MSTS score, the TESS and the RNL index

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Abstract

Limb-saving therapy for primary bone tumours is the treatment of choice. We aimed at analysing the quality of life of this group of patients by combining three different tools. Eighty-seven patients (46 females, 41 males) with a primary bone tumour of the extremity who had undergone endoprosthetic reconstruction between 1982 and 2000 were included in this retrospective study. The median age at the time of evaluation was 30 (12–73) years. The Toronto Extremity Salvage Score (TESS) and the Reintegration to Normal Living index (RNL) were recorded an average of 5.8 years after reconstruction and the Musculoskeletal Tumour Society Score (MSTS) after an average of 6.5 years. The mean MSTS score was 77% (13–93%). The mean TESS was 82% (22–99%), and the mean RNL index was 87% (32–98%). The subjective satisfaction and acceptance of physical impairment were significantly higher than the objective score (p < 0.001). The TESS was 88% in patients aged 12–25 years, 81% in those aged 26–40 years and 57% in those aged 41–73 years. Parallel recording of the MSTS score, TESS and RNL index provides a better measure reflecting the complex situation of the patients by combining objective and subjective parameters.

Résumé

La préservation du membre dans le traitement des tumeurs osseuses primitives des os doit être privilégiée. Le but de ce travail a été d’analyser la qualité de vie d’un groupe de patients dont le traitement a combiné différentes techniques. 87 patients (46 femmes et 41 hommes) présentant une tumeur primitive des extrémités osseuses et ayant bénéficié d’une endo prothèse entre 1982 et 2000 ont été inclus dans cette étude rétrospective. L’âge moyen au moment de l’évaluation des patients était de 30 ans (12 à 73 ans). Le score de Toronto ainsi que l’index RNL ont été utilisés en moyenne 5.8 ans après la reconstruction, de même que le score de la Société des Tumeurs Musculo-squeletiques. A à 6.5 ans en moyenne après le traitement. Le score MSTS moyen était de 77% (13 à 93%). Le score moyen TESS était de 82% (de 22 à 99%) et l’index RNL était de 87% (de 32 à 98%). La satisfaction des patients a été significativement plus élevée que l’évolution objective (p < 0.001). Le TESS était de 88% pour les patients âgés de 12 à 25 ans, de 81% chez les patients âgés de 26 à 40 ans et de 57% chez les patients plus âgés (de 41 à 73 ans). L’analyse des scores MSTS, TESS et de l’index RNL permet de mieux analyser les situations complexes de ces patients tant sur le plan objectif que subjectif.

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Authors and Affiliations

  1. Department of Surgery and Surgical Oncology, Charité Universitätsmedizin Berlin - Campus Buch, Robert-Rössle-Klinik, 13122, Berlin, Germany

    P. U. Tunn, D. Pomraenke, U. Goerling & P. Hohenberger

  2. Department of Surgery and Surgical Oncology, Charité Universitätsmedizin Berlin, Campus Buch, Robert-Rössle-Klinik, Helios-Klinikum Berlin, Lindenberger Weg 80, 13122, Berlin, Germany

    P. U. Tunn

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  1. P. U. Tunn
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  2. D. Pomraenke
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  3. U. Goerling
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  4. P. Hohenberger
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Correspondence to P. U. Tunn.

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Tunn, P.U., Pomraenke, D., Goerling, U. et al. Functional outcome after endoprosthetic limb-salvage therapy of primary bone tumours—a comparative analysis using the MSTS score, the TESS and the RNL index. International Orthopaedics (SICO 32, 619–625 (2008). https://doi.org/10.1007/s00264-007-0388-8

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