Background/Objectives: Bone reconstruction using megaprostheses is increasingly performed following bone tumour resections, including sarcomas, to enhance patient outcomes and quality of life. However, this is a complex patient group, and there is little consensus as to postoperative rehabilitation and associated outcomes. Methods: A systematic search was conducted in MEDLINE and EMBASE databases according to the Implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidelines. Studies describing rehabilitation protocols and functional outcomes following bone tumour resection and modular oncologic megaprosthesis reconstruction were included. All papers were individually assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool. Results: The search generated 105 records, 28 underwent full-text review, and 13 studies were included. Available data reflect 371 patients with a mean age of 49.17 (S.D. 21.40) years and a mean postoperative follow-up of 41.88 (S.D. 32.88) months. Surgical indications were documented as sarcomas in 9 studies, and tumour metastasis to the bone in 10 studies. Rehabilitation protocols were reported in 5 studies following proximal humerus resection with a mean dislocation rate of 14.5% (S.D. 5.26). All protocols advised brace immobilisation for a period ranging between 10 days and 6 months. Superior Constant-Murley shoulder score was reported in patients with early active isometric exercises at 6 weeks. Six studies reported proximal femur prosthesis rehabilitation and functional outcomes, with a mean dislocation rate of 10% (S.D. 9.82). Enhanced outcomes were reported in studies employing early mobilisation. Two studies assessed distal femur prosthesis; both studies reported similar protocols with full weight bearing 3 weeks following surgery. The methodological quality of the studies varied, but was overall modest, with 10/13 studies meeting at least 50% of JBI reporting criteria. Conclusions: The existing literature on rehabilitation and outcomes in orthopaedic oncology patients following arthroplasty with megaprosthesis is limited, with rehabilitative protocols variably described. However, it seems that early active mobilisation does not increase the risk of joint dislocations or infections.
背景/目的：为改善患者预后及生活质量，骨肿瘤（包括肉瘤）切除术后采用巨型假体进行骨重建的应用日益增多。然而，该患者群体情况复杂，关于术后康复方案及相关功能结局尚未形成共识。方法：依据《运动、康复、运动医学与运动科学领域PRISMA实施指南》（PERSiST），在MEDLINE和EMBASE数据库中进行系统性文献检索。纳入标准为描述骨肿瘤切除联合模块化肿瘤型巨型假体重建术后康复方案及功能结局的研究。采用乔安娜布里格斯研究所（JBI）批判性评估工具对所有文献进行方法学质量独立评估。结果：初检获得105条记录，经全文筛选后纳入13项研究，涉及371例患者，平均年龄49.17岁（标准差21.40），平均术后随访时间41.88个月（标准差32.88）。9项研究的手术指征为肉瘤，10项研究为骨转移瘤。5项研究报道了肱骨近端切除术后康复方案，平均脱位率为14.5%（标准差5.26）。所有方案均建议支具固定10天至6个月不等。研究显示术后6周开始早期主动等长训练的患者Constant-Murley肩关节评分更优。6项研究报道了股骨近端假体重建后的康复方案与功能结局，平均脱位率为10%（标准差9.82）。采用早期活动方案的研究显示出更好的功能结局。2项研究评估股骨远端假体，均报道了相似的康复方案（术后3周完全负重）。纳入研究的方法学质量存在差异，整体水平中等，13项研究中有10项满足至少50%的JBI报告标准。结论：目前关于骨科肿瘤患者巨型假体关节置换术后康复及功能结局的文献有限，康复方案描述存在差异。但现有证据表明，早期主动活动并未增加关节脱位或感染风险。
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