Comparison of Quality of Life of Patients after Hip Disarticulation and Those after Stump Lengthening with Modular Prosthesis Grzegorz Guzik Ortop Traumatol Rehabil 2017; 19(2):157-164 ICID: 1238003
Article type: Original article
IC™ Value: 3.00
Abstract provided by Publisher
Background. Disarticulation has been used less and less often in the treatment of musculoskeletal neoplasms; however, in some cases it allows the patient to achieve good oncological and functional outcomes. The aim of this paper is to present the possibilities, surgical technique and treatment outcomes of patients after hip disarticulation and stump lengthening with a modular prosthesis. Material and methods. Three classic hip disarticulation surgeries and 2 hip disarticulation procedures with stump lengthening with a modular prosthesis were performed at the Department of Oncological Orthopaedics in Brzozów in 2013 and 2014. The present paper discusses the indications, surgical technique and outcomes. Pain intensity was assessed in a VAS scale and physical function was measured with the Karnofsky scale. The mental status of the patients was analysed in the Beck Depression Inventory and the ability to perform daily living activities was evaluated according to Katz. The ability to walk after surgery was assessed. Results. Patients after hip disarticulation showed considerably worse functional outcomes. The mean physical function score was 53 points in the Karnofsky scale and 3.33 points in the Katz scale. The patients had difficulty walking and did not ambulate with their prostheses. They reported problems with sitting and using the toilet. Patients with lengthened stumps showed visibly better physical function scores, achieving, on average, 65 points in the Karnofsky scale and 5.5 points in the Katz scale. These patients used their prostheses, ambulated efficiently and were independent. Conclusions. 1. Stump lengthening after hip disarticulation through the preparation of long flaps and implantation of a custom-made femoral prosthesis significantly improves physical function and the quality of life of patients. 2. Prior to performing disfiguring surgery (disarticulation), the possibilities for modifying the surgical procedure should be considered, as this may considerably improve the patient’s functional status.