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Purpose: The aim of this study was to evaluate work ability, activity limitations and physical activity in adults that had gone through major bone sarcoma resection and reconstruction surgery in hip and knee. Materials and methods: Twenty patients, of 72 enrolled, and 20 controls were included in this cross-sectional study. Work Ability Index scores (general [0–10 points], physical and mental [1–5 points]), the Patient Specific Functional Scale (0–10 points), step counts and the International Physical Activity Questionnaire (IPAQ) were assessed. Adjusted and unadjusted general linear models were applied. Results: The patients had a mean age of 43 (range, 20–71) years and were assessed 7 years (range, 2–12) after surgery (proximal femoral n = 9, distal femoral n = 7, proximal tibia n = 4). Compared with controls, patients had lower general work ability (mean difference [95%CI], −1.3 points [−2.1, −0.5]) and work ability in relation to physical demands at work (−1.4 points [−2.0, −0.8]). The patients reported higher severities of activity limitation (−6.7 points [−7.9, −5.4]). There were no between-group differences in step counts or IPAQ-scores. Conclusion: Despite similar levels of physical activity, patients showed poorer work ability and severe activity limitation. Post-operative rehabilitation in patients of the working-age population should include assessments of work ability and activities important to the individual.IMPLICATIONS FOR REHABILITATION Adults that have gone through resection and reconstruction surgery following bone sarcoma in lower extremity show clinically relevant reductions in work ability and self-selected activities To tailor post-operative rehabilitation at short and long term, initial assessment and monitoring should include work ability and activities important to the individual patient.

Objectives: Previous multicenter studies report variable outcomes and failure rates after tumor-prosthetic reconstructions. The purpose of this study was (I) to evaluate implant survival, limb survival, and functional outcome in a cohort of patients who underwent resection of primary malignancies or aggressive benign bone tumors and reconstruction with modern tumor-prostheses in the lower extremities and (2) to provide comparison to a historical cohort on previous generations of tumor-prostheses from the same center.Methods: A longitudinal retrospective single-center study of 72 consecutive patients (F/M = 30/42), mean age = 44 (range = 7-84) years with bone, soft tissue sarcoma adjacent to bone (n = 69), and aggressive benign bone tumors (n = 3) having surgery between 2006 and 2016 with bone resection and reconstruction with tumor-prostheses were compared to a historical cohort from 1985 to 2005. Revisions were classified as major and minor revisions. Causes of failure were classified according to the Henderson classification. Fine and Gray competing risk analysis was used for assessing cumulative incidence for implant revision and limb amputation. Functional outcome was evaluated with Musculoskeletal Tumor Society Score system.Results: Forty-seven patients were alive at the end of the study. Mean follow-up was 6years (range = 2-13 years). Ten-year cumulative risk of major revision was 18% (95% confidence interval = 9%-28%). Deep infection and recurrence of tumor caused most revisions in modern tumor-prostheses. Ten-year cumulative incidence of limb amputation was 1 1 % (95% confidence interval = 3%-18%). According to the Henderson classification, the overall predominant failure mode was non-mechanical (n = 20, 51%). Mean Musculoskeletal Tumor Society Score was 20 (67%) (range = 0-30).Conclusion: A minimum of 2 years follow-up with modern modular tumor-prostheses demonstrated a relatively low risk of implant failure and amputation and also a

BACKGROUND: Patients with a bone sarcoma who undergo limb-sparing surgery and reconstruction with a tumor prosthesis in the lower extremity have been shown to have reduced self-reported physical function and quality of life (QoL). To provide patients facing these operations with better expectations of future physical function and to better evaluate and improve upon postoperative interventions, data from objectively measured physical function have been suggested. QUESTIONS/PURPOSES: We sought to explore different aspects of physical function, using the International Classification of Functioning, Disability, and Health (ICF) as a framework, by asking: (1) What are the differences between patients 2 to 12 years after a bone resection and reconstruction surgery of the hip and knee following resection of a bone sarcoma or giant cell tumor of bone and age-matched controls without walking limitations in ICF body functions (ROM, muscle strength, pain), ICF activity and participation (walking, getting up from a chair, daily tasks), and QoL? (2) Within the patient group, do ICF body functions and ICF activity and participation outcome scores correlate with QoL? METHODS: Between 2006 and 2016, we treated 72 patients for bone sarcoma or giant cell tumor of bone resulting in bone resection and reconstruction with a tumor prosthesis of the hip or knee. At the timepoint for inclusion, 47 patients were alive. Of those, 6% (3 of 47) had undergone amputation in the lower limb and were excluded. A further 32% (14 of 44) were excluded because of being younger than 18 years of age, pregnant, having long transportation, palliative care, or declining participation, leaving 68% (30 of 44) for analysis. Thus, 30 patients and 30 controls with a mean age of 51 ± 18 years and 52 ± 17 years, respectively, were included in this cross-sectional study. Included patients had been treated with either a proximal femoral (40% [12 of 30]), distal femoral (47% [14 of 30]), or proximal tibia (13% [4