AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025360376
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ORIGINAL RESEARCH ARTICLE

Early ambulation during hospitalization after lower limb salvage surgery for bone and soft-tissue sarcomas: An observational retrospective study

Mattia Morri1* ,  Marco Cotti2 ,  Riccardo Ruisi2 ,  Pietro Cimatti3 ,  Davide Maria Donati4
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1 Department of Nursing, Technical, and Rehabilitation Service, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy
2 Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy
3 Reconstructive Orthopaedic Surgery Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy
4 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy
EJMO, 025360376 https://doi.org/10.36922/EJMO025360376
Received: 3 September 2025 | Revised: 27 October 2025 | Accepted: 2 December 2025 | Published online: 22 January 2026
(This article belongs to the Special Issue Nursing Care in Cancer)
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Evidence on early functional recovery and inpatient physiotherapy after lower limb salvage surgery for bone sarcomas is limited.

Objective: This study aims to describe early ambulation and explore potential prognostic factors.

Methods: A retrospective cohort study was conducted, including patients aged 12–70 years with bone and soft-tissue sarcoma who underwent lower limb resection and reconstruction between 2019 and 2023. The primary outcome was time to ambulation, and the secondary outcome was length of hospital stay.

Results: A total of 84 patients were included in this study. The median time to ambulation was 4 post-operative days (interquartile range [IQR], 4), and the median length of stay was 8 (IQR, 4). In multivariable Cox regression, earlier ambulation was associated with tumor location in the diaphysis/other sites (hazard ratio [HR] = 4.39, p=0.002), older age (HR = 1.02 per year, p=0.006), and higher physiotherapy intensity when initiated on post-operative day 1 (HR = 1.74, p=0.001). Bone graft/other procedures were associated with a lower hazard of ambulation compared with prosthetic reconstruction (HR 0.46, p=0.037). Each additional day of ambulation was associated with a 12% lower hazard of discharge (HR = 0.88, p=0.009).

Conclusion: Early mobilization and intensive physiotherapy appear to facilitate functional recovery following lower limb salvage surgery for bone and soft-tissue sarcomas. These findings emphasize the value of structured, staff-led rehabilitation programs that actively encourage and guide recovery, highlighting the role of clinical staff in optimizing post-operative outcomes and may improve patients’ independence.

Keywords
Bone sarcoma
Physiotherapy
Early ambulation
Lower limb salvage surgery
Risk factors
Length of stay
Funding
This research was funded by the Ministry of Health, through the 5 million 2021 contribution (income year 2020) to the Rizzoli Orthopaedic Institute (grant no. 5M-2021- 23683816).
Conflict of interest
The authors declare they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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