Revision surgeries for tumor endoprostheses around the knee joint: a mid-long-term follow-up of 20 cases.
Revision surgeries for tumor endoprostheses around the knee joint: a mid-long-term follow-up of 20 cases.
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DOI：
10.1186/s12957-022-02542-0
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发表时间：
2022-03-10
影响因子：
3.2
通讯作者：
Sun W
中科院分区：
文献类型：
--
作者：
Zan P;Wang H;Cai Z;Shen J;Sun W
肿瘤性膝关节假体保肢术后并发症发生率高，给延期翻修手术带来了巨大挑战。本研究的目的是总结膝关节肿瘤内假体翻修的失败率、功能结局和假体存活率。回顾性分析2000年1月至2018年1月20例恶性肿瘤保肢术后假体翻修患者的临床资料。该队列由11例男性和9例女性患者组成，平均年龄为34.1岁（范围：16 - 66岁）。感染病例在最初取出假体后接受二期翻修，而所有其他病例均接受一期翻修。详细记录并分析了翻修原因和并发症。所有患者均接受了完整的随访，平均随访时间为64.7个月（范围，27至155个月）。共6（6/20，30.0%）例患者在翻修手术后发生二次并发症，其中1例深部感染患者在假体翻修后发生反复感染并接受截肢手术; 1例假体骨折翻修患者发生感染并接受二期感染翻修; 1例因假体松动翻修后出现深部感染，经抗感染治疗后假体仍在原位，1例出现伤口并发症，经2次清创手术后愈合; 1例MBGCT患者在初次松动后6年发生第二次无菌性松动，因此进行了第二次翻修; 1例复发性骨肉瘤患者在翻修手术后3年死于肺转移。Kaplan-Meier生存曲线显示初次修复的5年生存率为75%。与翻修前的评分[17.2（范围，13 - 21分）]相比，翻修术后1年的肌肉骨骼肿瘤协会（MSTS-93）评分[20.9（范围，15 - 27分）]显著改善（p < 0.001）。假体机械问题、无菌性松动和感染是膝关节肿瘤假体翻修的主要原因。虽然翻修手术复杂，但仍有较高的失败风险，这仍然是这些患者保肢和功能恢复的补救策略。
Tumor endoprostheses of the knee joint after limb salvage surgery is associated with high rates of complications, which has introduced great challenges to a delayed revision surgery. The aim of the study was to summarize the failures, functional outcomes and prosthetic survival in revision tumor endoprostheses of the knee joint. The clinical data of 20 patients with malignant tumors who received prosthetic revisions after limb salvage surgery from January, 2000 until January, 2018 were retrospectively reviewed. The cohort was constituted of 11 male and 9 female patients with a mean age of 34.1 years (range, 16 to 66 years). Infection cases received two-stage revisions after removing prostheses initially, while all other cases received one-stage revisions. Revision reasons and complications were well documented and analyzed. All patients received complete follow-up with a mean time of 64.7 months (range, 27 to 155 months). A total of 6 (6/20, 30.0%) patients experienced a second complication after revision surgery, of whom, one patient with deep infection experienced repeated infections after prosthetic revision and received amputation surgery; one patient revised of prosthetic fracture experienced an infection and received a second-stage infection revision; one case revised of prosthetic loosening had deep infection receiving anti-infective therapy with prostheses still in position; one case having wound complication healed after receiving two times of debridement surgery; one MBGCT patient experienced a second aseptic loosening 6 years after the initial loosening thus undergoing a second revision; a recurrent osteosarcoma patient died of pulmonary metastasis 3 years after revision surgery. Kaplan-Meier survival curve indicated a 5-year survival rate of initial prostheses was 75%. The Musculoskeletal Tumor Society (MSTS-93) score [20.9 (range, 15 to 27 scores)] at 1 year after revision surgeries was significantly improved (p < 0.001) when compared with the score [17.2 (range, 13 to 21 scores)] before revisions. Prosthetic mechanical problems, aseptic loosening and infections were primary reasons for revisions after tumor endoprostheses of the knee joint. Although revision surgeries were complicated while still associated with high risk of failure, which remains the remedy strategy for limb salvage and functional recovery in those patients.
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影响因子：
5.3
作者：
Jeys, L. M.;Kulkarni, A.;Abudu, A.
通讯作者：
Abudu, A.
自体股骨头植骨手术切除重建技术治疗原发性盆腔恶性肿瘤引起的部分髋臼缺损
影响因子：
3.8
作者：
Sun, Wei;Zan, Pengfei;Cai, Zhengdong
通讯作者：
Cai, Zhengdong
DOI：
10.1302/0301-620x.89b4.18631
发表时间：
2007-04-01
影响因子：
--
作者：
Myers, G. J. C.;Abudu, A. T.;Grimer, R. J.
通讯作者：
Grimer, R. J.
DOI：
10.1097/01.jaa.0000541477.24116.8d
发表时间：
2018-08-01
影响因子：
1.1
作者：
Simpson, Emily;Brown, Heather L.
通讯作者：
Brown, Heather L.
DOI：
10.23750/abm.v88i2
发表时间：
2017-06-07
期刊：
Acta bio-medica : Atenei Parmensis
影响因子：
--
作者：
Dall'Oca, Carlo;Ricci, M;Magnan, B
通讯作者：
Magnan, B