Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 11, pp 1507–1516 | Cite as

Functional outcomes and quality of life in patients with osteosarcoma treated with amputation versus limb-salvage surgery: a systematic review and meta-analysis

  • Jiong Mei
  • Xiao-Zhong Zhu
  • Zhi-Yuan Wang
  • Xuan-Song Cai
Orthopaedic Surgery



To perform a meta-analysis for comparing the functional outcomes and quality of life (QOL) of osteosarcoma patients receiving amputation or limb-salvage surgeries.

Materials and methods

A search was conducted of the Medline, Cochrane, EMBASE, and Google Scholar on September 30, 2013. Studies were included in the analysis if there were patients who underwent amputation and limb-salvage surgery for osteosarcoma or Ewing’s sarcoma, and for whom postoperative functional outcomes and QOL were evaluated. Outcomes were compared between participants who underwent limb-salvage operation and those who underwent amputation. The methodological quality of non-randomized comparative studies was assessed using the Newcastle–Ottawa Scale.


A total of 121 studies were identified and 6 were included in the meta-analysis. Quality assessment indicated that all six studies were of high quality. The mean age of the participants ranged from 17 to 37 years, and among them 118 underwent amputations and 138 underwent limb-salvage procedures. The mean length of follow-up ranged from 28 to 145 months. The meta-analysis indicated that functional outcomes and QOL were similar between patients who underwent amputation and those who underwent a limb-salvage procedure.


This meta-analysis including six high-quality studies indicates that amputation and limb-salvage surgery provide similar functional outcomes and quality of life for patients with osteosarcomas.


Osteosarcoma Ewing’s sarcoma Amputation Limb salvage Quality of life Function 



Standardized mean difference


Confidence interval


System for functional evaluation of the American Musculoskeletal Tumor Society


Toronto Extremity Salvage Score


Short form 36


Physical functioning


Physical role


Bodily pain


General health perceptions




Social functioning


Emotional role


Mental health


Physical component summary


Mental component summary


Hazard ratio


Not available


Conflicts of interest

None to declare.

Supplementary material

402_2014_2086_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jiong Mei
    • 1
  • Xiao-Zhong Zhu
    • 1
  • Zhi-Yuan Wang
    • 1
  • Xuan-Song Cai
    • 1
  1. 1.Department of OrthopaedicsTongji Hospital of Tongji UniversityShanghaiChina

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