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Hip Transposition Can Provide Early Walking Function After Periacetabular Tumor Resection: A Multicenter Study.
Liuzhe Zhang1,2, Shintaro Iwata3, Masanori Saito4
1Department of Orthopedic Surgery, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Clinical Orthopaedics and Related Research
|May 15, 2023
Summary
Hip transposition for periacetabular bone tumors requires significant recovery time. Early functional recovery by postoperative day 60 is linked to better long-term outcomes and higher Musculoskeletal Tumor Society (MSTS) scores.
Area of Science:
- Orthopedic oncology
- Surgical reconstruction
- Rehabilitation medicine
Background:
- Periacetabular bone tumor resection presents reconstruction challenges with tradeoffs between function and complications.
- Hip transposition is an alternative to grafts or endoprostheses, potentially reducing implant risks but with less predictable functional return.
- Limited data exists on the functional recovery timeline following hip transposition, especially in resource-constrained settings.
Purpose of the Study:
- To determine the time course of walking function recovery after hip transposition, focusing on the initial six months.
- To identify factors associated with earlier functional recovery post-surgery.
- To assess if early functional recovery (at two months) predicts later walking ability and higher Musculoskeletal Tumor Society (MSTS) scores.
Main Methods:
- Retrospective study of 44 patients undergoing hip transposition for malignant tumors between 2009-2019.
- Follow-up of at least six months for patients without local recurrence.
- Assessment of functional milestones (e.g., walker, crutches, independent walking) and MSTS scores, analyzing demographic and surgical factors.
Main Results:
- Patients used walkers by median postoperative day (POD) 20 and bilateral crutches by POD 35.
- At POD 60, 76% could walk with bilateral crutches (early recovery group); these patients had significantly higher MSTS scores (57% vs. 45%) and achieved better functional levels sooner.
- Forty-two percent required additional surgery for wound management.
Conclusions:
- Functional recovery after hip transposition is prolonged, with early recovery by POD 60 correlating with better long-term MSTS scores.
- Patients not achieving ambulation with bilateral crutches by POD 60 may have poorer functional outcomes.
- Hip transposition is a viable option for select patients, but frequent wound complications necessitate careful management; further research on risk factors for delayed recovery is needed.
