This cross-sectional study assessed the functional outcomes of patients who underwent curettage followed by defect reconstruction, correlating these outcomes with quality-of-life indicators from two validated questionnaires: the Lower Extremity Functional Scale (LEFS) and the Musculoskeletal Tumor Society (MSTS) score.
We measured knee range of motion (ROM) for flexion and extension using a goniometer. Thigh circumference (CIR) was assessed at 6 cm and 15 cm above the patella, and limb length discrepancies were evaluated from the umbilicus to the mid-malleolus. Quadriceps strength (QS) was measured isometrically with the knee flexed to 60° and an isometric dynamometer placed at the distal tibia. Functional performance was evaluated using the Five Times Sit-to-Stand Test (5-STST) and the Timed Up and Go (TUG) test.
Comparative analyses were conducted between the affected knee and the contralateral side for ROM, CIR, limb length, and QS. Functional test results were benchmarked against normative data. Correlation studies utilized Spearman's correlation coefficient, with calculations performed using Graph Pad Prism (version 8.0.2) at a significance level of 5%.
A total of nine subjects participated in this study: seven with GCT, one with ABC, and one with CF, all localized in the distal femur (five males, four females). Comparison of affected knee ROM with the contralateral side revealed that only two subjects had a greater than ten-degree difference in knee flexion, while three showed similar discrepancies in extension. Thigh circumference differences exceeding two centimeters were noted in 4/9 subjects at 6 cm above the patella and in 3/9 at 15 cm, all on the affected side. One individual exhibited a limb length discrepancy, with the affected side being shorter. QS was reduced in the affected limb for seven of the nine subjects.
Functional assessments indicated that 7/9 subjects did not meet normative standards on the 5-STST, whereas all but one achieved normative performance in the TUG test (8/9). High scores were recorded on the MSTS (mean: 26.1, SD [5.9]) and LEFS (mean: 76%, SD [0.21]) questionnaires for all but two participants. Correlation analysis between QS and MSTS showed no significant relationship for the right quadriceps (r=0.3726; p>0.05), but a strong correlation for the left (r=0.7018; p0.05). Additionally, the average QS correlated negatively with significant differences in the 5-STST (r=-0.75; p0.05) and TUG (r=-0.80; p0.05).
In conclusion, while curettage may partially restore functionality, static assessments indicate satisfactory knee function, contrasting with poorer outcomes in functional tests. The correlation between QS and functional performance underscores the need for targeted rehabilitation strategies to enhance quadriceps strength and overall outcomes post-surgery.
Curettage restores some functionality; however, rehabilitation is essential to enhance quadriceps strength and improve overall functional performance.
knee tumors
functional assessment
