Rehabilitation after bone cancer surgery

After surgery to treat bone cancer, your recovery depends on where the cancer was, the surgery used and many other factors. You will need to have physical rehabilitation after surgery for bone cancer. Rehabilitation can help you return to the activities of daily living after surgery.

The most important part of rehabilitation is to help you learn to walk or move again. Rehabilitation can help you be more independent and manage possible problems after bone cancer surgery. It can also help you adjust to changes in your environment or lifestyle.

Several different healthcare professionals may be on your rehabilitation team. These include:

Physiotherapists, or physical therapists, help you keep or return to a level of fitness by using strength and endurance exercises. They teach exercises and physical activities to help keep muscles strong and flexible or restore strength and movement.

Occupational therapists will look at your home and work or school environments. They will recommend changes or tools to improve your mobility and help you cope with daily activities.

Prosthetists are specially trained to design, make and fit people with artificial limbs called prostheses. A prosthesis is used to replace an arm or leg after it has been amputated.

Members of your rehabilitation team will usually meet with you before bone cancer surgery to explain:

• what to expect after surgery
• the type of rehabilitation you will need
• where you will go for your rehabilitation
• the type of prosthesis that will be made for you

If you’ve had bone cancer surgery, you may have the following concerns about rehabilitation.

Limb-sparing surgery is more complicated than amputation, so it takes longer to recover from it. It can take about a year to learn to walk again after limb-sparing surgery. During that time, rehabilitation is very important for your recovery. After surgery, your rehabilitation team will teach you exercises to build up the strength and flexibility in your muscles and to keep your joints bending and moving. Without rehabilitation, the spared limb may become too weak or difficult to use and might eventually need to be amputated.

To help support the reconstructed limb, you may need to wear a sling, brace or splint. You may also have to use crutches for a while because you can’t put your full weight on your leg until the bone graft has completely healed with the remaining bone. After using crutches, you may still need to use a cane or walker for a time until your leg fully heals.

A bone graft can be easily broken, so you may not be able to do high-impact activities that can put stress on your leg, such as hockey or soccer. Low-impact activities, like swimming or riding a bike, are safe to do with a bone graft.

If you have an endoprosthesis to replace a joint in your hip or knee, your rehabilitation team will teach you how to move properly so that you don’t damage the endoprosthesis. You will also be given exercises to make your legs and hips stronger.

Rehabilitation is faster after an amputation than limb-sparing surgery because the amputation surgery is not as complicated.

After surgery, your rehabilitation team will help you recover from your amputation. They will teach you how to care for the end of the limb left after amputation (called the stump). Caring for your stump includes learning the following:

• how to keep the skin on the stump clean and healthy, as well as how to look for any skin problems
• exercises that help strengthen and tone the muscles and keep the joints moving well
• how to bandage the stump after surgery to shape it to fit into your prosthesis and decrease swelling

Your rehabilitation team can help you to find ways to change your home and workplace to help you move around and cope in your daily life.

Most people will use a prosthesis after amputation. A prosthesis is designed and made for each person. Before and after your surgery, a prosthetist will measure you to make sure that the prosthesis will fit you properly. The prosthetist will design and make a prosthesis that will fit your activities and lifestyle. You may have more than one type of prosthesis depending on your needs. You may have some options for the type of prosthesis that you can use, such as special types for sports or swimming.

You may be given a temporary prosthesis to use until your stump has healed. When the stump has completely healed, the prosthetist will fit your new prosthesis and make any changes to make sure it works properly.

A prosthesis is fitted to the stump. The prosthetist will teach you the right way to put your prosthesis on and take it off. They will also teach you how to put on an elastic wrap or stump sock to protect the stump before putting on your prosthesis.

You will slowly increase the amount of time you wear the prosthesis until you are wearing it all day. During this time, you will have to learn how to walk, move and use the prosthesis. This can take a few months of rehabilitation and physical therapy. You may have to use a cane, wheelchair, walker or crutches until you have learned to walk with a new leg prosthesis. Depending on where they had the amputation, many people with a prosthesis can return to the same level of activity that they had before surgery. People who have an amputation below the knee often recover better than those who have an amputation above the knee or of an arm.

Some people may not be able to use a prosthesis because of their age, ability or health. They may have to use a wheelchair or other mobility aid to move around.