The push-through total femoral prosthesis offers a functional alternative to total femoral replacement: a case series
The push-through total femoral prosthesis offers a functional alternative to total femoral replacement: a case series
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DOI：
10.1007/s00264-017-3467-5
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发表时间：
2017-11-01
影响因子：
2.7
通讯作者：
Jutte, Paul C.
中科院分区：
文献类型：
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作者：
Gorter, Jelle;Ploegmakers, Joris J. W.;Jutte, Paul C.
目的肿瘤切除术或节段性股骨假体的并发症可导致严重的股骨骨丢失，需要全股骨假体（TFP）。这项研究评估了是否可以通过使用推入式全股骨内假体（PTTF）来改善由肌肉附着丧失引起的稳定性和功能丧失，因为它保留了部分股骨及其肌肉附着。方法在这项回顾性病例系列中，10名25-77岁（平均54岁）的患者在2005年至2014年期间接受了PTTF，并发症和生存分析，平均随访5.3（1.1-9.6）年。采用肌肉骨骼肿瘤学会（MSTS）评分、WHO行为能力量表、多伦多生活质量评分（TESS）、SF-36、EQ-5D、NRS疼痛评分、疲劳评分和满意度评分对6例患者进行功能评价。5例患者的WHO表现量表为1分，1例患者为3分。平均TESS为69%（13-90%）。SF 36最明显的限制是身体功能（平均48），活力（68）和一般健康（67）。疼痛、疲劳和满意度的NRS评分分别为1.9、1.8和8.3。有四个失败：2例感染（1例导致截肢，1例轻微翻修）和2例机械失效（1例需要翻修TFP，1例轻微翻修）。患者存活率100%，肢体存活率90%，假体存活率80%。结论推入式全股骨假体可保留肌附着，是一种较好的替代全股骨假体的方法。
Purpose Oncologic resections or complications of segmental femoral prostheses can result in severe bone loss of the femur for which a total femoral prosthesis (TFP) is required. This study assesses whether the loss of stability and function caused by the loss of muscle attachments can be improved by using a push-through total femoral endoprosthesis (PTTF), because it saves parts of the femur and its muscle attachments.Methods In this retrospective case series, ten patients aged 25-77 (mean 54) who received a PTTF between 2005 and 2014 were included for baseline, complications and survival analysis with a mean follow-up of 5.3 (1.1-9.6) years. Functional outcome was assessed in six patients using the Musculoskeletal Tumor Society (MSTS) score, WHO performance scale, Toronto Extremity Salvage Score (TESS), SF36, EQ-5D, NRS pain score, fatigue score and satisfaction score.Results The mean MSTS score was 64%(23-93%). Five patients had a WHO performance scale of 1, one patient of 3. Mean TESS was 69% (13-90%). SF36 was most notably limited by physical functioning (mean 48), vitality (68) and general health (67). NRS score was 1.9, 1.8 and 8.3 for pain, fatigue and satisfaction, respectively. There were four failures: two infections (one resulting in amputation and one in a minor revision) and two mechanical failures (which required one revision to a TFP and one minor revision). Patient survival was 100%, limb survival 90%, and prosthesis survival 80%.Conclusion The push-through total femoral endoprosthesis allows preservation of muscle attachments and offers a good alternative to total femoral prostheses.