title: [Rehabilitation pathway after knee arthroplasty with mega prosthesis in osteosarcoma].
abstract: BACKGROUND
  The knee is the most frequent location for osteosarcoma (60%). Until 30 years ago patients with osteosarcoma were treated with an amputation of the affected limb; today 85% of these cases are treated with a "Limb Salvage" procedure, through replacement of the affected bone with a mega prosthesis implant.
  
  
  OBJECTIVE
  To measure functional recovery of patients with a knee mega-prosthesis and how rehabilitation impacts on quality of life (QOL); another aim is to define rehabilitation guidelines to manage these patients in the rehabilitation pathway.
  
  
  METHODS
  A sample of outpatients with knee mega-prosthesis were selected in the follow-up orthopedic oncology surgery between march and may 2013. We measured the functional outcome using the multidimensional standardized Musculoskeletal Tumor Society scale (MSTS) that gives a score (0-5) for each of 7 items: pain, range of motion, stability, deformity, strength, functional activity, emotional acceptance.
  
  
  RESULTS
  The sample included 28 outpatients. The median MSTS score was 29 (min 19, max 33) equal to 83%. Only 14 patients (50%) followed a correct rehabilitation path after surgery.
  
  
  CONCLUSIONS
  21 cases got "excellent" outcomes and 3 "good" (based on MSTS classification). In few cases (n 4) the outcome was "fairly good", related to necessity of a prosthesis surgical revision based on instability of implant (because of usage). Quadricep strength is the item that most affects the final score. There is a statistically significant correlation between high scores and patients who have recently undergone surgery. We found higher scores in patients that followed a physiotherapy program after surgery: the difference was statistically significant.
  
  
  CONCLUSIONS
  Mega-prosthesis implants give satisfactory functional outcomes. These outcomes keep high score in time. It is recommended to follow the guidelines described in the purposed rehabilitation program.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lopresti
authors.forename: Jacopo
authors.initials: J
authors.lastname: Rancati
authors.forename: Erika
authors.initials: E
authors.lastname: Farina
authors.forename: Stefano
authors.initials: S
authors.lastname: Bastoni
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bernabè
authors.forename: Tiziana
authors.initials: T
authors.lastname: Succetti
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ligabue
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Panella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001859:Bone Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery; D007720:Knee Prosthesis; D023821:Limb Salvage / Q000379:methods; D008875:Middle Aged; D053580:Muscle Strength; D012516:Osteosarcoma / Q000534:rehabilitation* / Q000601:surgery; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D011474:Prosthesis Design; D011788:Quality of Life; D016059:Range of Motion, Articular; D055815:Young Adult