Gait and health-related quality of life outcomes following proximal femoral tumor resection and reconstruction with tensioning of the abductor musculotendinous unit.

Abstract

Although proximal femoral tumors are common, there is little information on outcomes following proximal femoral tumor resection and endoprosthetic reconstruction with reattachment of the hip abductors on tension. The objective of this study is to determine the effect of this surgery on gait and health-related quality of life. Participants ≥18 years old and ≥ 2 years after proximal femoral resection with endoprosthetic reconstruction and reattachment of hip abductors on tension were compared to controls in this cross-sectional study. Three-dimensional instrumented gait data were collected at preferred- and fast-walking speeds. Health-related quality of life indices were obtained using the SF-36. Knee flexor and extensor maximal strength was quantified using an isokinetic dynamometer. Surgical versus control limbs were compared using Welch's t-tests, while operative participants' surgical versus non-surgical limbs were compared using paired t-tests (p < 0.05). Fourteen participants (7 operative, 7 control) were included. Surgical limbs exhibited decreased hip and knee flexion angles, hip abductor and knee extensor moments, and knee power generation compared to non-surgical limbs. Comparison of surgical and control limbs revealed a significant reduction in knee joint motion, knee extensor and abductor moments, and knee power generation, however no significant differences were observed for any variable at the hip. Mean health-related quality of life exceeded national averages. Despite differences in hip and knee kinematics and kinetics, proximal femoral resection with tensioning of the abductor musculotendinous unit was associated with relatively normal health-related quality of life.