Rehabilitation for limb salvage patients: kinesiological parameters and psychological assessment

Osteosarcoma is the most frequently occurring primary malignant tumor of bone, especially in adolescence. Treatment involves either limb salvage surgery or amputation with neoadjuvant chemotherapy. This review article discusses the current treatment modalities for osteosarcoma and also compares the gait patterns and psychosocial profiles of patients treated with either limb salvage surgery or amputation for osteosarcoma. Contemporary orthopedic literature on therapeutic options for osteosarcoma patients is reviewed. Background information on the basic principles of kinesiology, with emphasis on studies of gait pattern differences among patients treated with limb salvage versus amputation, is presented. Finally, several studies of the psychologic profiles of patients after these two procedures for osteosarcoma are reviewed. Trends in contemporary orthopedic literature suggest that functional outcomes, in terms of kinesiologic parameters, are comparable for patients treated with either limb salvage or amputation. Both sets of patients reported quality-of-life problems, including difficulty retaining health insurance and finding appropriate employment, social isolation, and poor self-esteem. The management of patients with osteosarcoma includes not only an individualized surgical plan for each patient but also includes awareness of the patients' psychologic and social needs after surgery.