Sebastian Fischer1, Silke Soimaru2, Tobias Hirsch2, Maximilian Kueckelhaus2, Christoph Seitz3, Marcus Lehnhardt2, Ole Goertz2, Hans-Ulrich Steinau4, Adrien Daigeler5. 1. BG Trauma Center Ludwigshafen - Department of Hand-Plastic and Reconstructive Surgery, Burn Center, University of Heidelberg, Germany. 2. BG University Hospital Bergmannsheil - Department of Plastic and Reconstructive Surgery, Burn Center, Ruhr University Bochum, Germany. 3. University Children's Hospital Heidelberg - Department of Neonatology, Heidelberg, Germany. 4. University Clinic Essen - Tumor Center of West-Germany/Sarcoma Centre, University of Essen, Germany. 5. BG University Hospital Bergmannsheil - Department of Plastic and Reconstructive Surgery, Burn Center, Ruhr University Bochum, Germany. Electronic address: adrien.daigeler@bergmannsheil.de.
Abstract
PURPOSE: Aim of this study was to measure the outcome of hamstring transfer for quadriceps reconstruction after soft tissue sarcoma resection and to identify risk factors influencing postoperative results. METHODS: 43 patients underwent hamstring transfer after sarcoma resection. Medical records were reviewed for surgical technique and complications. Physical examination included assessment of range of motion and muscle strength as well as plantar pressure distribution by computerized dynamometer and podometry, respectively. Additionally, patients' satisfaction, quality of life and karnofsky index were assessed. RESULTS: Sole biceps transfer was performed in 31 (74%) and combined biceps/semitendinosus or gracilis transfer in 12 patients (26%). In 91%of cases 3/4 or more of the quadriceps muscle had to be removed. Postoperative complications occurred in 16 patients (37%). 17 patients (40%) were available for physical examination. Mean follow-up was 61 months (22-107). Average knee flexion was 74° (35-110°). All patients had full knee extension. Average extension force was 44% (19-79%) and flexion-force 74% (55-100%) of the unaffected leg. Mean plantar pressure distribution was 119% (44-200%) on the forefoot and 107% (60-169%) on the heel. Average patient satisfaction score was 16 (9-25), quality of life assessment was 78 (54-92) and Karnofsky Index was 82% (70-90%). Besides patient's age and the extent of resection, the surgical technique had statistically significant influence on functional outcome and postoperative complications (p < 0.05). CONCLUSION: Hamstring transfer is feasible for quadriceps reconstruction after massive tumor resection from the thigh. In contrast to biceps alone, combined semitendinosus or gracilis transfer revealed comparable outcome but higher complication rates.
PURPOSE: Aim of this study was to measure the outcome of hamstring transfer for quadriceps reconstruction after soft tissue sarcoma resection and to identify risk factors influencing postoperative results. METHODS: 43 patients underwent hamstring transfer after sarcoma resection. Medical records were reviewed for surgical technique and complications. Physical examination included assessment of range of motion and muscle strength as well as plantar pressure distribution by computerized dynamometer and podometry, respectively. Additionally, patients' satisfaction, quality of life and karnofsky index were assessed. RESULTS: Sole biceps transfer was performed in 31 (74%) and combined biceps/semitendinosus or gracilis transfer in 12 patients (26%). In 91%of cases 3/4 or more of the quadriceps muscle had to be removed. Postoperative complications occurred in 16 patients (37%). 17 patients (40%) were available for physical examination. Mean follow-up was 61 months (22-107). Average knee flexion was 74° (35-110°). All patients had full knee extension. Average extension force was 44% (19-79%) and flexion-force 74% (55-100%) of the unaffected leg. Mean plantar pressure distribution was 119% (44-200%) on the forefoot and 107% (60-169%) on the heel. Average patient satisfaction score was 16 (9-25), quality of life assessment was 78 (54-92) and Karnofsky Index was 82% (70-90%). Besides patient's age and the extent of resection, the surgical technique had statistically significant influence on functional outcome and postoperative complications (p < 0.05). CONCLUSION: Hamstring transfer is feasible for quadriceps reconstruction after massive tumor resection from the thigh. In contrast to biceps alone, combined semitendinosus or gracilis transfer revealed comparable outcome but higher complication rates.
Authors: John T Kim; Benjamin M Kasukonis; Lemuel A Brown; Tyrone A Washington; Jeffrey C Wolchok Journal: Exp Gerontol Date: 2016-07-17 Impact factor: 4.032
Authors: Benjamin Kasukonis; John Kim; Lemuel Brown; Jake Jones; Shahryar Ahmadi; Tyrone Washington; Jeffrey Wolchok Journal: Tissue Eng Part A Date: 2016-09-23 Impact factor: 3.845
Authors: Dimitra Kotsougiani-Fischer; Sebastian Fischer; Jan Warszawski; Paul A Gruetzner; Gregor Reiter; Christoph Hirche; Ulrich Kneser Journal: BMC Surg Date: 2021-03-29 Impact factor: 2.102
Authors: Dide den Hollander; Winette T A Van der Graaf; Marco Fiore; Bernd Kasper; Susanne Singer; Ingrid M E Desar; Olga Husson Journal: ESMO Open Date: 2020-10