Patients' quality of life and function evaluation after successful management of infected segmental bone defects with the induced membrane technique.

Introduction: This study aimed to evaluate the health perception of quality of life and function in patients with segmental bone defects (SBD) of the femur or tibia treated with the Induced Membrane Technique (IMT) and achieved bone healing and infection control.

Methods: This cross-sectional cohort study was conducted at a single referral center. Patients with infected SBD of the femur or tibia treated with IMT were included if they had at least 12 months of bone healing and no evidence of infection. Three questionnaires were administered: the EuroQol five-dimensional questionnaire (EQ-5D), the short form 36 (SF-36), and the lower extremity functional score (LEFS).

Results: The final cohort consisted of 33 patients, with a mean age of 39 ± 16.7 years. Twenty defects involved the tibia. The average bone defect measured 6 cm (range 3.5-12). The median healing time was 7.4 months (range 3-14), with 30 patients (90.9%) achieving healing without reoperation. The average follow-up period from the second stage was 46 months (range 20-85). Questionnaires were completed on average at 30 months (range 15-70) after bone healing was recorded. The mean EQ-5D VAS score was 63.63 ± 13.20, and the EQ-5D index was 0.72 ± 0.26. In the SF-36, the mean MCS was 52.8 ± 3.2, and the PCS was 46.45 ± 3.9. The mean LEFS score was 65 ± 4.8, with a range of 55 to 73. Overall, out of the 5, the EQ-5D mobility and pain/discomfort had the lowest scores, whereas in the LEFS, the items indicating limitations required greater physical demand, such as walking more than a mile, running, and jumping.

Conclusion: Despite successful bone healing and infection control with the IMT, patients with infected femoral or tibial SBD continue to experience an impaired quality of life more than 2 years after treatment. Although functional and mental scores were relatively acceptable, patients reported physical limitations and discomfort with certain tasks, highlighting ongoing challenges in their physical recovery.