Follow up
Subsequently, the patient required three additional surgical debridements during the first month after surgery to achieve adequate healing of the stump.
He underwent postoperative rehabilitation to achieve an early prosthetic adaptation. At ten months postoperatively, a radiographic union of the osteotomy site was evident; his stump healed well with a good hip range of motion. He was allowed to full weight bearing, achieving complete prosthetic fitting 11 months after the surgery. Two years postoperatively, he ambulated with the transfemoral prosthesis using a single cane (Figure 5); he referred to feeling well and resumed his work with minor limitations.
At the most recent follow-up (28 months postoperatively), we applied the MSTS (Musculoskeletal Tumor Society Score, lower limb) (5) with a total score of 18 (pain 4 points, functional capacity 3 points, walking ability 3 points, emotional acceptance 3 points, use of gait support 3 points and gait 2 points. Each of these items was evaluated on a 5-point scale, with a maximum total score of 30 points, assumed as 100%), compared with a total of 7 points before the surgery. The most significant changes were in pain control and improvement in gait pattern. The real proportional gain was 36% (taking 30 points as 100%).