This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by KAWAI, A.
Right arrow Articles by HEALEY, J. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by KAWAI, A.
Right arrow Articles by HEALEY, J. H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery 80:822-31 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Interrelationships of Clinical Outcome, Length of Resection, and Energy Cost of Walking after Prosthetic Knee Replacement following Resection of a Malignant Tumor of the Distal Aspect of the Femur*

AKIRA KAWAI, M.D., PH.D.{dagger}, SHERRY I. BACKUS, M.A., P.T.{ddagger}, JAMES C. OTIS, PH.D.{ddagger} and JOHN H. HEALEY, M.D.{dagger}, NEW YORK, N.Y.

Investigation performed at the Memorial Sloan-Kettering Cancer Center and The Hospital for Special Surgery, New York City

The relationships between the functional score according to the system of the International Society of Limb Salvage, the extent of resection, energy cost of walking, and gait characteristics were studied in thirty-six patients who had had segmental knee replacement after resection of a malignant tumor of the distal aspect of the femur. The mean free-walking velocity was 62.3 meters per minute (79 per cent of normal), which was a result of decreases in both cadence and stride length. The mean net energy cost during walking was 35 per cent greater than that of normal controls and correlated with the percentage of the femur that had been resected. All patients had decreased single-limb support time on the affected side compared with the unaffected side. There was a weak correlation between the asymmetry of the single-limb support time and the percentage of the femur that had been resected. The mean extensor torque of the affected knee was 30 per cent that of the unaffected knee when one head of the quadriceps muscle had been excised, 19 per cent when two heads had been excised, 4 per cent when three heads had been excised, and 1 per cent when four heads had been excised. The patients who had had an extra-articular resection had lower mean extensor and flexor torques at the knee compared with those who had had an intra-articular resection. The asymmetry of the single-limb support time was inversely related to the residual extensor and flexor torques. The overall score according to the system of the International Society of Limb Salvage ranged from 17 to 29 points (mean, 24.6 points; 82 per cent of normal). The net energy cost, percentage of maximum aerobic capacity, and asymmetry of the single-limb support time had significant negative correlations with the overall functional score. Multivariate analysis showed that the overall functional score and the percentage of the femur that had been resected were the two most important factors that predicted the net energy cost. To our knowledge, this is the first objective validation of the functional score according to the system of the International Society of Limb Salvage. As the net energy cost can be predicted from universally available, inexpensive measures, investigators can easily use it as a clinical and research tool to evaluate prosthetic performance and to assess operative outcome.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
W.-C. Li, R.-S. Yang, and J.-Y. Tsauo
Knee Proprioception in Patients with Osteosarcoma Around the Knee After Modular Endoprosthetic Reconstruction
J. Bone Joint Surg. Am., April 1, 2005; 87(4): 850 - 856.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
M. R. DiCaprio and G. E. Friedlaender
Malignant Bone Tumors: Limb Sparing Versus Amputation
J. Am. Acad. Ortho. Surg., January 1, 2003; 11(1): 25 - 37.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
A. Kawai, T. Miyakawa, M. Senda, H. Endo, N. Naito, M. Umeda, and H. Inoue
Gait Characteristics After Limb-Sparing Surgery with Sciatic Nerve Resection : A Report of Two Cases
J. Bone Joint Surg. Am., February 1, 2002; 84(2): 264 - 268.
[Full Text] [PDF]

Home page
 JBJSHome page
M. G. Benedetti, F. Catani, D. Donati, L. Simoncini, and S. Giannini
Muscle Performance About the Knee Joint in Patients Who Had Distal Femoral Replacement After Resection of a Bone Tumor : An Objective Study with Use of Gait Analysis
J. Bone Joint Surg. Am., November 1, 2000; 82(11): 1619 - 1619.
[Abstract] [Full Text]

Home page
 JBJSHome page
A. HILLMANN, D. ROSENBAUM, J. SCHRÖTER, G. GOSHEGER, C. HOFFMANN, and W. WINKELMANN
Electromyographic and Gait Analysis of Forty-three Patients After Rotationplasty
J. Bone Joint Surg. Am., February 1, 2000; 82(2): 187 - 96.
[Abstract] [Full Text]