Original ArticlesA functional analysis of massive knee replacement after extra-articular resections of primary bone tumors*,**
Section snippets
Materials and methods
Twelve patients underwent massive knee replacement after an extra-articular resection of bone tumor between 1992 and 1996. Of these 12 patients, 3 subsequently died of their bone tumor disease and have been excluded from the study. The remaining 9 patients were case matched by percentage bone resection to patients who had undergone massive knee replacement after intra-articular resection of bone tumor. In all patients, the type of device used was a cemented custom-made Smiles prosthesis
Background data
There were 9 patients in each group. The average age at follow-up of the extra-articular resection group was 32.7 years (range, 20-64 years), and of the intra-articular resection group was 29.6 years (range, 17-48 years). There were 6 men and 3 women in the extra-articular resection group compared with 4 men and 5 women in the intra-articular resection group. Patient follow-up in the extra-articular resection group was an average of 2 years, 6 months (range, 6 months to 4 years, 8 months), with
Discussion
The results of this study suggest that the functional outcome of massive knee replacement after extra-articular resection for primary bone tumors is inferior to that obtained after intra-articular resection.
Summary
In our study, patients with massive knee replacements after extra-articular resection did not score as highly with MTSS and KSS as case-matched patients with massive knee replacements after intra-articular resection. After extra-articular resection, lower scores were achieved for emotional acceptance, functional restriction, walking distance, and managing stairs. These patients have a significantly greater extension lag and greater fixed flexion when compared with the intra-articular resection
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2021, Journal of Bone OncologyCitation Excerpt :There was no statistically significant difference in functional outcomes between the EAR and IAR groups. A previous study of EAR of malignant primary bone tumours at the knee joint described worse functional outcomes compared with those of IAR primarily due to the compromised extensor mechanisms [29]. However, the following reports demonstrated comparable function between the EAR and IAR groups with preservation of the extensor mechanism [30,31].
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2017, European Journal of Surgical OncologyCitation Excerpt :Post-operative functional results and the differences between IAR and EAR resections continue to be debated. One study described poorer functional outcome after extra-articular resections for primary bone tumours compared with intra-articular resections and this functional deficit was primarily due to a compromised extensor mechanism.19 Another group believed that EAR of the knee presents comparable functional scores to those having an IAR.2
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No benefits or funds were received in support of this study.
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Reprint requests: S. J. H. Kendall, PhD, FRCS, 11 Galveston Road, Putney, London SW15 2RZ, UK.