Extracorporeally Irradiated Autograft-Prosthetic Composite Arthroplasty Using AML® Extensively Porous-Coated Stem for Proximal Femur Reconstruction: A Clinical Analysis of 14 Patients
Extracorporeally Irradiated Autograft-Prosthetic Composite Arthroplasty Using AML® Extensively Porous-Coated Stem for Proximal Femur Reconstruction: A Clinical Analysis of 14 Patients
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DOI：
10.1002/jso.21351
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发表时间：
2009-10-01
影响因子：
2.5
通讯作者：
Chen, Tain-Hsiung
中科院分区：
文献类型：
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作者：
Chen, Cheng-Fong;Chen, Wei-Ming;Chen, Tain-Hsiung
背景和目标：同种异体骨-假体复合材料在股骨近端肿瘤切除后的重建中被广泛用作巨型假体的替代品。为了实现更好的生物学固定，我们采用了一种长柄假体，该假体近端用骨水泥固定在体外辐照的自体移植物中，远端压配到宿主股骨中，而不使用任何辅助钢板固定连接处，而不是标准的全骨水泥技术。方法：从1997年到2002年，14名患者接受了股骨近端重建，采用经体外照射的自体移植物-假体复合材料，使用AML（R）广泛多孔-结果：平均随访65.7个月，1例（8.1%）发生骨不连，1例在骨连接处愈合前死亡。其余12例患者（85%）平均愈合时间为20.3周（范围：14-40周），无严重并发症。平均功能Enneking评分为72.1%（范围，53-93%）。结论：这些临床结果表明，这种可靠和令人满意的技术促进愈合，通过在宿主-移植物连接处加压，通过使股骨柄远端部分未固定到宿主骨中来承重。外科肿瘤学杂志2009;100：418-422. (C)2009 Wiley-Liss，Inc.
Background and Objectives: Allograft-prosthetic composite for reconstruction of the proximal femur after tumor excision is widely used as ail alternative to megaprosthesis. To achieve greater biological fixation, we employed a long-stem prosthesis that is cemented proximally into the extracorporeally irradiated autograft and press-fit distally into the host femur without any supplementary plate fixation of the junction instead of the standard all-cemented technique,Methods: From 1997 to 2002, 14 patients underwent proximal femur reconstruction with extracorporeally irradiated autograft-prosthetic composite using an AML (R) extensively porous-coated long stem for reconstruction of the bone defect of tumor excisions.Results: At the mean follow-Lip period of 65.7 months, only one patient (8.1%) developed non-union and another died of disease before union of the junction. The remaining 12 patients (85%) achieved union at a mean of 20.3 weeks (range, 14-40 weeks) without major complication. The mean functional Enneking score was 72.1% (range, 53-93%).Conclusions: These clinical results show that this reliable and satisfactory technique promotes union through compression at the host-graft junction with weight-bearing by leaving the distal portion of the femoral stein uncemented into the host bone. J. Surg. Oncol. 2009;100:418-422. (C) 2009 Wiley-Liss, Inc.