Patient survival after hip arthroplasty for metastatic disease of the hip
Patient survival after hip arthroplasty for metastatic disease of the hip
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DOI：
10.2106/00004623-200408000-00011
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发表时间：
2004-08-01
影响因子：
5.3
通讯作者：
Scully, SP
中科院分区：
文献类型：
--
作者：
Schneiderbauer, MM;Von Knoch, M;Scully, SP
背景：髋关节是转移性疾病的常见部位。该部位的实际骨折和即将发生的骨折通常是由于肿瘤侵袭后机械不稳定造成的，通常通过手术进行髋关节置换术治疗。本研究的目的是分析转移性髋关节疾病髋关节置换术后的生存率及其影响因素。方法：1969年至1996年间，299例患者接受了306例半髋关节置换术或全髋关节置换术治疗病理性或即将发生的病理性髋部骨折，纳入本研究。回顾性地审查了在我们机构的总联合登记处内前瞻性地获得的数据。结果：关节置换术后的中位生存期为8.6个月。生存时间与骨折部位、原发肿瘤位置、原发肿瘤诊断至骨折手术时间相关（p <等于0.05）。从诊断到关节置换术的时间是生存率的重要独立预测因子。结论：接受髋关节置换术治疗转移性疾病的患者预期寿命有限，在我们研究的299例患者中，只有40%（120例）在手术后一年仍然存活。通过确定与预期寿命有关的预后因素，本研究为外科医生和肿瘤学家提供了在术前衡量单个患者髋关节置换术的风险和益处的信息。证据等级：预后研究，II-1级（回顾性研究）。有关证据水平的完整描述，请参见作者说明。
Background: The hip joint is a common location for metastatic disease. Actual as well as impending fractures at this site are frequently due to mechanical instability after tumor invasion and are usually treated surgically with hip arthroplasty. The objective of this study was to analyze survival and influences on survival after hip arthroplasty for metastatic hip disease.Methods: Two hundred and ninety-nine patients who had undergone a total of 306 hemiarthroplasty or total hip arthroplasty procedures for treatment of a pathologic or an impending pathologic hip fracture between 1969 and 1996 at our institution were included in this study. Data that had been acquired prospectively within the total joint registry of our institution were reviewed retrospectively.Results: The median duration of survival after the arthroplasty was 8.6 months. The duration of survival was significantly associated with the site of the fracture, location of the primary tumor, and time from the diagnosis of the primary tumor to the surgery for the fracture (p less than or equal to 0.05). The time from the diagnosis to the arthroplasty was a significant independent predictor of survival.Conclusions: Patients undergoing hip arthroplasty for metastatic disease have a limited life expectancy, with only 40% (120) of the 299 patients in our series still alive at one year after the surgery. By identifying prognostic factors regarding life expectancy, this study provides surgeons and oncologists with information with which to weigh risks and benefits of hip arthroplasty for individual patients preoperatively.Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.