Internal and External Hemipelvectomy or Flail Hip in Patients with Sarcomas Quality-of-Life and Functional Outcomes

Griesser MJ, Gillette B, Crist M, Pan X, Muscarella P, Scharschmidt T, Mayerson J: Internal and external hemipelvectomy of flail hip in patients with sarcomas: quality-of-life and functional outcomes. Am J Phys Med Rehabil 2012;91:24-32. Objective: We evaluated the quality-of-life of patients who have had an internal hemipelvectomy with and without (flail hip) prosthetic reconstruction and external hemipelvectomy. Design: We reviewed the cases of 15 patients who had undergone either internal or external hemipelvectomy for tumor. Fifteen patients who were previously treated operatively with either a type II periacetabular internal (n = 5) or external (n = 10) hemipelvectomy were evaluated using the Toronto Extremity Salvage Score (TESS), Musculoskeletal Tumor Society (MSTS), and the 36-item Short-Form Health Survey. There were 11 (73%) men and 4 (27%) women in the study, with a mean age at operation of 46.9 +/- 18.0 yrs (range, 18-69 yrs). Results: Follow-up was 30.6 +/- 19.6 mos (range, 6-70 mos). Overall mean MSTS score was 45.2 (range, 6.7 to 83.3), and TESS score was 60.4 +/- 16.1 (range, 31.8-88.0). The 36-item Short-Form Health Survey physical component score results were lower than the general population. TESS and MSTS were all positively correlated to physical component score. There were no significant influences of postsurgery time on MSTS, TESS, or physical component score. Age had a negative correlation with physical function. Conclusions: Quality-of-life and functional outcome were significantly reduced for patients with internal and external hemipelvectomies on the TESS, MSTS, and the 36-item Short-Form Health Survey physical component scores.