Role of Amputation in Improving Mobility, Pain Outcomes, and Emotional and Psychological Well-Being in Children With Metastatic Osteosarcoma.
Sebastian Gil, Israel Fernandez-Pineda, Bhaskar Rao and 5 others
PMID 30058346WHAT IT FOUND
After amputation, records showed better mobility in eight of twelve children with metastatic osteosarcoma and limited life expectancy, lower pain at one week and three months, and improved emotional wellbeing in nine.
Key findings
0111 of 12 patients were wheelchair bound or bedridden before surgery, and eight improved to ambulating independently with a prosthesis or crutches.
02Pain score range was 0 to 10. Median score was 5.5 one week before surgery, 3 one week after, and 0 three months after; scores were not different at six months.
03Family and staff quotes indicated improved emotional and psychological wellbeing in nine of 12 children, with no evidence of regret; three had persistent symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The analysis included only 12 children, so it cannot show whether amputation caused the changes. It was retrospective and had no comparison group. Mobility, pain, and emotional outcomes were taken from chart notes, not standardized assessments. Improvement and regret were defined from quotes, which may miss symptoms. One child died 15 days after surgery and had no mobility data, and pain or opioid data were missing at some timepoints. All patients had chemotherapy, and some had radiation, so the effect of amputation alone cannot be separated. Only children who died within one year were analyzed, so long-term outcomes were not studied.
The easy way to misread this
Do not read this as proof that amputation causes better mobility, pain, or emotional outcomes. It was a retrospective chart review of 12 children with no comparison group, all had chemotherapy and some had radiation, pain scores were not different at six months, and opioid doses did not significantly change.