title: The Significance of Rectus Femoris for the Favorable Functional Outcome After Total Femur Replacement.
abstract: BACKGROUND
  In treatment of tumors, we usually reconstruct after resection of the entire femur using only metallic modular endoprostheses among many procedures and defined it as a total femur replacement. We studied the interrelation between the preservation of rectus femoris and the functional outcome after total femur replacement.
  
  
  METHODS
  We rated the functional outcomes of 21 patients who underwent total femur replacement. We categorized the subjects into 2 groups: group A (rectus femoris preserved) and group B (rectus femoris unpreserved). We examined them based on the Mann-Whitney U test between the 2 groups in average through the Musculoskeletal Tumor Society functional scores.
  
  
  RESULTS
  The average score of group A was 20 of 25 (11-25; 80%), whereas the average score of group B was 10 of 25 (4-13; 40%). There was significant difference between the groups (P = 0.00168877).
  
  
  CONCLUSIONS
  We found that the preservation of rectus femoris is imperative for achieving the favorable functional outcome in total femur replacement.
authors.affiliation: Department of Orthopedic Oncology, Cancer Institute Hospital, Koto-ward, Tokyo, Japan; and Department of Orthopaedic Surgery (Ohashi), School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Orthopedic Oncology, Cancer Institute Hospital, Koto-ward, Tokyo, Japan; and Department of Orthopaedic Surgery (Ohashi), School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopedic Oncology, Cancer Institute Hospital, Koto-ward, Tokyo, Japan; and Department of Orthopaedic Surgery (Ohashi), School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimoji
authors.affiliation: Department of Orthopedic Oncology, Cancer Institute Hospital, Koto-ward, Tokyo, Japan; and Department of Orthopaedic Surgery (Ohashi), School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ae
authors.affiliation: Department of Orthopedic Oncology, Cancer Institute Hospital, Koto-ward, Tokyo, Japan; and Department of Orthopaedic Surgery (Ohashi), School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Tanizawa
authors.affiliation: Department of Orthopedic Oncology, Cancer Institute Hospital, Koto-ward, Tokyo, Japan; and Department of Orthopaedic Surgery (Ohashi), School of Medicine, Toho University, Tokyo, Japan.
authors.forename: Tabu
authors.initials: T
authors.lastname: Gokita