Gait and health-related quality of life outcomes following proximal femoral tumor resection and reconstruction with tensioning of the abductor musculotendinous unit

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-05-18 DOI:10.1016/j.clinbiomech.2025.106561

Jennifer R. Kallini, Eileen G. Fowler, Lindsay Pietruszewski, Andy Vuong, Marcia B. Greenberg, Nicholas J. Jackson, Rachel Thompson, Nicholas Bernthal, Kristen Stearns-Reider

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引用次数: 0

Abstract

Background

Although proximal femoral tumors are common, there is little information on outcomes following proximal femoral tumor resection and endoprosthetic reconstruction with reattachment of the hip abductors on tension. The objective of this study is to determine the effect of this surgery on gait and health-related quality of life.

Methods

Participants ≥18 years old and ≥ 2 years after proximal femoral resection with endoprosthetic reconstruction and reattachment of hip abductors on tension were compared to controls in this cross-sectional study. Three-dimensional instrumented gait data were collected at preferred- and fast-walking speeds. Health-related quality of life indices were obtained using the SF-36. Knee flexor and extensor maximal strength was quantified using an isokinetic dynamometer. Surgical versus control limbs were compared using Welch's t-tests, while operative participants' surgical versus non-surgical limbs were compared using paired t-tests (p < 0.05).

Findings

Fourteen participants (7 operative, 7 control) were included. Surgical limbs exhibited decreased hip and knee flexion angles, hip abductor and knee extensor moments, and knee power generation compared to non-surgical limbs. Comparison of surgical and control limbs revealed a significant reduction in knee joint motion, knee extensor and abductor moments, and knee power generation, however no significant differences were observed for any variable at the hip. Mean health-related quality of life exceeded national averages.

Interpretation

Despite differences in hip and knee kinematics and kinetics, proximal femoral resection with tensioning of the abductor musculotendinous unit was associated with relatively normal health-related quality of life.

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股骨近端肿瘤切除和外展肌腱单位张力重建后的步态和健康相关生活质量

虽然股骨近端肿瘤很常见，但关于股骨近端肿瘤切除和髋关节外展肌张力复位假体内重建的结果的信息很少。本研究的目的是确定手术对步态和健康相关生活质量的影响。方法：在本横断面研究中，年龄≥18岁且在股骨近端切除术后进行假体内重建和髋外展肌张力再附着≥2年的受试者与对照组进行比较。在首选和快速步行速度下收集三维仪器步态数据。使用SF-36获得健康相关生活质量指数。膝关节屈肌和伸肌的最大力量用等速测功机量化。使用Welch’st检验比较手术与对照肢体，使用配对t检验比较手术参与者的手术与非手术肢体(p <；0.05)。结果纳入14例患者（手术7例，对照组7例）。与非手术肢体相比，手术肢体表现出髋关节和膝关节屈曲角度、髋关节外展肌和膝关节伸肌力矩以及膝关节发电量的减少。手术肢与对照肢的比较显示，膝关节运动、膝关节伸肌和外展肌力矩以及膝关节发电量显著减少，但在髋关节的任何变量上均未观察到显著差异。与健康有关的平均生活质量超过全国平均水平。解释：尽管髋关节和膝关节的运动学和动力学存在差异，但股骨近端切除伴外展肌腱单位张力与相对正常的健康相关生活质量相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.