The role of perioperative rehabilitation of patients in surgical treatment of pelvic and lower extremity bone tumors with endoprosthesis

The main method of treatment for tumor lesions of the bones of the pelvis and lower extremities is resection of the affected bone with endoprosthesis. Functional results after oncologic endoprosthetics remain unsatisfactory in 35—40% of cases. The need to improve functional outcomes is a significant medical and social problem. Objective. To evaluate the influence of perioperative rehabilitation on functional results in oncologic patients undergoing surgical treatment with pelvic and lower limb bone resection with endoprosthesis. Material and methods. A comprehensive analysis of the treatment results of 348 patients who underwent resection of the affected pelvic and lower limb bones with endoprosthesis was performed. There were 150 (43.1%) men and 198 women (56.9%), the average age was 51.3 (19—82) years. The distribution of patients by volume and type of surgical intervention was as follows: pelvic bone resection with the use of “Lumic” type endoprosthesis was performed in 23 patients; resection of proximal femur with endoprosthesis — 124; resection of distal femur with endoprosthesis — 108; resection of proximal tibia with endoprosthesis — 75; resection of distal tibia with endoprosthesis — 6; resection of diaphyses of long bones — 12 patients. Results. In the group using the perioperative rehabilitation program, which included 167 patients, the functional results were better than in the group that did not receive the rehabilitation complex and were 81.2%. Mechanical complications were detected in 18 (10.7%) patients. The average functional results in 181 patients from the group that did not receive a full-fledged perioperative rehabilitation complex amounted to 71.8%, and mechanical complications were found in 24 patients (13.25%). Conclusion. Full-fledged perioperative rehabilitation is an important component, it significantly improves the functional outcome of the operated limb, contributes to earlier activation, restoration of self-care in the shortest time after surgery. Improvement of functional results in patients also reduces the risk of mechanical complications.