A limb-sparing pelvectomy is a life-changing experience, requiring extensive postoperative care, including physical therapy. In an internal pelvectomy, doctors remove part of your pelvis without amputating your leg. The prevalence of this surgery is unknown, according to the "Journal of the American Physical Therapy Association," but it has emerged as a life-saving option for those suffering from sarcoma, a deadly form of bone cancer. While the surgery saved your leg and your life, physical therapy can help you reconstruct both.
Limb Sparing Therapy Effectiveness
Postoperative care for the limb sparing pelvectomy patient is effective, despite the bone and muscle lost during the procedure. A study performed by The University of Texas MD Anderson Cancer Center compared patients admitted to an in-patient rehabilitation center. The study found a patient who had undergone an internal, or limb sparing, pelvectomy had shorter lengths of stay in the facility, less favorable outcome and required more extensive pain management. At the time of discharge, 47 percent of internal pelvectomy patients could walk unassisted whereas only 17 percent of amputees could do so.
Considerations
The rehabilitative process is dependent on how much bone and soft tissue your surgeon had to remove, the level of reconstruction and your overall condition. It may take up to a year to regain motor strength, especially if your surgeon performed a resection and reconstruction for a periacetabular tumor. Recuperation times will be relative to the amount of reconstruction your surgeon performed to the muscles of your hip or if cancer required an extensive pelvic resection.
CPM
You may wake up from surgery already engaging in continuous passive motion, or CPM. A CPM machine continuously and slowly bends and straightens your leg, helping you exercise even when you are asleep. CPM prevents your joints from growing stiff, which reduces your range of motion and slows your rehabilitation. You may rent or purchase a CPM machine to use after discharge from the hospital to further improve your mobility.
Therapy
The quantity of bone loss and type of reconstruction dictates how soon and how much you can exercise -- most patients start therapy sessions the day after surgery. Therapy will help you learn again how to perform simple tasks involving your hip, like sitting or walking. Therapy includes muscle strengthening and range of motion exercises targeting those muscle groups reconstructed and repositioned during surgery, as well as overcoming the changes accompanying structural losses, like trying to sit straight with an incomplete pelvis.
Aside from its therapeutic value, physical therapy gets you out of bed, removing pressure from your surgical site. Your physical therapist will help you grow accustomed to using assistive devices like canes or hip girdles. Your therapist can also recommend exercises to help you maintain good health throughout your lifetime, after you have completed treatment for the disorder which required a limb sparing pelvectomy procedure.
References
- Journal of the American Physical Therapy Association: Functional Outcomes and Quality of Life After Tumor-Related Hemipelvectomy; Lisa A Beck, Marlene J Einertson, et al; August 2008
- University of Texas MD Anderson Cancer Center: Comparison of Postoperative Rehabilitation in Cancer patients Undergoing Internal and External Hemipelvectomy; Guo Y, Fu J, Palmer JL, et al; April 2011
