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63 Rehabilitative Protocols and Functional Outcomes in Oncological Patients Treated with Megaprosthesis Reconstruction: A Systematic Review

Year: 2025
Type: article
Study design: Systematic Review
Abstract: Aim The number of megaprosthesis reconstructions after bone tumour resections has increased, yet no clear postoperative rehabilitation guidelines exist. The aim of this systematic review was to assess rehabilitation protocols following megaprosthesis surgery and associated functional outcomes. Method A systematic search was conducted in MEDLINE and EMBASE databases according to the updated PERSiST guidelines. Studies describing rehabilitation protocols and functional outcomes following oncological megaprosthesis reconstruction were included. All papers were individually assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool. Results The literature search generated 109 records, 25 were eligible for full text review and 11 studies were included in the analysis. In total there were 308 patients with a mean age of 52.75 (S.D. 20.45). The mean patient follow-up period was 31.44 months. Rehabilitation protocols were assessed in 5/11 studies following proximal humerus resections with a mean dislocation rate of 14.5% (range 10-20%). Superior Constant shoulder score was reported in patients with early active exercises at 6 weeks. Proximal femur prosthesis rehabilitation protocol and functional outcomes were discussed in 5/11 studies, with mean reported dislocation rate of 12% (range 4-25%). Lower VAS scores were reported with protocols advising early mobilisation with independent weight bearing at 2 months. The methodological quality of the studies varied, however 8/11 studies met at least 50% of evaluation criteria on the JBI appraisal tool. Conclusions There is much heterogeneity in protocols and measure outcomes. However, the results overall suggest that early mobilisation does not increase the risk of prosthesis dislocations and increases functional outcomes.
DOI: 10.1093/bjs/znaf128.674
Language: English
Field: Medicine
Open Access status: bronze
OpenAlex ID: W4411683082
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