Functional analysis of cases of tumor endoprostheses with deep infection around the knee

A multi institutional study by the Japanese Musculoskeletal Oncology Group (JMOG)

Takeshi Morii, Hideo Morioka, Takafumi Ueda, Nobuhito Araki, Nobuyuki Hashimoto, Akira Kawai, Katsuhito Takeuchi, Ukei Anazawa, Kazuo Mochizuki, Shoichi Ichimura

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Although intensive studies have been conducted to clarify the incidence, risks, and management methods of deep infection of tumor endoprostheses, limited data have been published in respect of the impact of such deep infection on the function of the corresponding limb. Methods: Clinical data of 125 patients (infection group 57, control group 68) with malignant bone and soft tissue tumors around the knee enrolled with the Japanese Musculoskeletal Oncology Group were collected. We analyzed the impact of deep infection of tumor endoprostheses on the limb salvage status together with that on the function of the salvaged limb. The definition of deep infection was based on the recommendations of the Centers for Disease Control and Prevention. The functional evaluation was based on the functional classification system established by the International Society of Limb Salvage and the Musculoskeletal Tumor Society. Results: Infection together with extracapsular resection was demonstrated to be a risk factor for late amputation. There were no significant differences in the functional scores for "pain," "support," "walking," or "gait" between the infection and control groups. The risk factors identified for a loss of score for "functional activities" were deep infection, age, duration of operation, and extracapsular resection. The infection group also showed a significant lower score loss in "emotion". As for the overall functional scores, the risk factors identified for lower scores were deep infection and age. The mean scores for the infection group and control group were 19.3 (64.3 %) and 21.6 (72 %), respectively. Although the difference was confirmed to be statistically significant, the actual difference was only 2.3 (10.6 % reduction). Conclusions: Infection was a major risk factor for late amputation. Limbs salvaged by management of deep infection may show loss of function; however, the impact may be limited.

Original languageEnglish
Pages (from-to)605-612
Number of pages8
JournalJournal of Orthopaedic Science
Volume18
Issue number4
DOIs
Publication statusPublished - 2013 Jul

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Knee
Infection
Neoplasms
Limb Salvage
Extremities
Infection Control
Amputation
Control Groups
Risk Management
Centers for Disease Control and Prevention (U.S.)
Gait
Walking
Emotions
Bone and Bones
Pain
Incidence

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Functional analysis of cases of tumor endoprostheses with deep infection around the knee : A multi institutional study by the Japanese Musculoskeletal Oncology Group (JMOG). / Morii, Takeshi; Morioka, Hideo; Ueda, Takafumi; Araki, Nobuhito; Hashimoto, Nobuyuki; Kawai, Akira; Takeuchi, Katsuhito; Anazawa, Ukei; Mochizuki, Kazuo; Ichimura, Shoichi.

In: Journal of Orthopaedic Science, Vol. 18, No. 4, 07.2013, p. 605-612.

Research output: Contribution to journalArticle

Morii, Takeshi ; Morioka, Hideo ; Ueda, Takafumi ; Araki, Nobuhito ; Hashimoto, Nobuyuki ; Kawai, Akira ; Takeuchi, Katsuhito ; Anazawa, Ukei ; Mochizuki, Kazuo ; Ichimura, Shoichi. / Functional analysis of cases of tumor endoprostheses with deep infection around the knee : A multi institutional study by the Japanese Musculoskeletal Oncology Group (JMOG). In: Journal of Orthopaedic Science. 2013 ; Vol. 18, No. 4. pp. 605-612.
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T1 - Functional analysis of cases of tumor endoprostheses with deep infection around the knee

T2 - A multi institutional study by the Japanese Musculoskeletal Oncology Group (JMOG)

AU - Morii, Takeshi

AU - Morioka, Hideo

AU - Ueda, Takafumi

AU - Araki, Nobuhito

AU - Hashimoto, Nobuyuki

AU - Kawai, Akira

AU - Takeuchi, Katsuhito

AU - Anazawa, Ukei

AU - Mochizuki, Kazuo

AU - Ichimura, Shoichi

PY - 2013/7

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AB - Background: Although intensive studies have been conducted to clarify the incidence, risks, and management methods of deep infection of tumor endoprostheses, limited data have been published in respect of the impact of such deep infection on the function of the corresponding limb. Methods: Clinical data of 125 patients (infection group 57, control group 68) with malignant bone and soft tissue tumors around the knee enrolled with the Japanese Musculoskeletal Oncology Group were collected. We analyzed the impact of deep infection of tumor endoprostheses on the limb salvage status together with that on the function of the salvaged limb. The definition of deep infection was based on the recommendations of the Centers for Disease Control and Prevention. The functional evaluation was based on the functional classification system established by the International Society of Limb Salvage and the Musculoskeletal Tumor Society. Results: Infection together with extracapsular resection was demonstrated to be a risk factor for late amputation. There were no significant differences in the functional scores for "pain," "support," "walking," or "gait" between the infection and control groups. The risk factors identified for a loss of score for "functional activities" were deep infection, age, duration of operation, and extracapsular resection. The infection group also showed a significant lower score loss in "emotion". As for the overall functional scores, the risk factors identified for lower scores were deep infection and age. The mean scores for the infection group and control group were 19.3 (64.3 %) and 21.6 (72 %), respectively. Although the difference was confirmed to be statistically significant, the actual difference was only 2.3 (10.6 % reduction). Conclusions: Infection was a major risk factor for late amputation. Limbs salvaged by management of deep infection may show loss of function; however, the impact may be limited.

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