title: Work status after distal femoral Kotz reconstruction for malignant tumors of bone.
abstract: OBJECTIVE
  To determine the proportion of patients who experienced altered work status after reconstruction with a modular tumor prosthesis and adjuvant chemotherapy for primary sarcoma of the distal femur.
  
  
  METHODS
  We reviewed an institution's tumor database and patients' charts. Disability and work status data were collected preoperatively, at 1 year and 2 years postoperatively and at final follow-up.
  
  
  METHODS
  Acute-care teaching hospital in Ontario, Canada.
  
  
  METHODS
  Thirty-six eligible patients.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Work status was plotted over time to identify unexpected deviations (based on age and preoperative status), and subjects were assigned to altered work status (defined by detrimental changes in productivity, eg, change from full-time work to not working) or expected work status (defined by ongoing work or students progressing to higher education). Disability was measured with the Toronto Extremity Salvage Score and the Musculoskeletal Tumor Society score.
  
  
  RESULTS
  Nine patients (25%) experienced altered work status. There were no significant differences in disability ratings or demographic information between the 2 groups. Baseline job demand and living environment (rural vs urban, P=.001) were predictive by logistic regression.
  
  
  CONCLUSIONS
  Patients with physically demanding jobs, and those living rurally, are at greatest risk for altered work status.
authors.affiliation: University Musculoskeletal Oncology Unit, and Department of Rehabilitation Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Brown
authors.forename: Janet A
authors.initials: JA
authors.lastname: Parsons
authors.forename: Carolyn
authors.initials: C
authors.lastname: Martino
authors.forename: Anthony
authors.initials: A
authors.lastname: Griffin
authors.forename: Robert S
authors.initials: RS
authors.lastname: Bell
authors.forename: Jay S
authors.initials: JS
authors.lastname: Wunder
authors.forename: Aileen M
authors.initials: AM
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005266:Femoral Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation; D012516:Osteosarcoma / Q000534:rehabilitation / Q000601:surgery; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012509:Sarcoma / Q000534:rehabilitation* / Q000601:surgery; D014938:Work Capacity Evaluation