Clinical outcomes of endoprosthetic reconstruction for proximal femoral resection
Clinical outcomes of endoprosthetic reconstruction for proximal femoral resection
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DOI：
10.1093/jjco/hyab087
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发表时间：
2021-06-08
影响因子：
2.4
通讯作者：
Song, Won Seok
中科院分区：
文献类型：
--
作者：
Kim, Yongsung;Jeon, Dae-Geun;Song, Won Seok
简介：股骨近端是原发性肉瘤和转移性病变的常见部位。虽然肿瘤假体的早期结果是有希望的，但重建的长期结果尚不清楚。本研究的目的是评估股骨近端切除和重建后影响假体存活率和并发症的预后因素。方法：我们回顾了2005年至2017年间68例接受股骨近端切除和重建的患者的结果。平均随访时间为55.6个月（范围6-172个月）。有50名男性和18名女性患者，平均年龄为41.5岁（范围11-80岁）。采用累积生存分析法分析影响假体生存的危险因素。我们还评估了术后并发症。结果：14例（21%）患者需要进一步手术，平均37个月后（范围5-125个月）。感染3例（4%），局部复发6例（9%），髋臼侵蚀3例（4%），股骨柄松动2例（3%）。5年时种植体存活率为83.9%，10年时为59.8%。假体存活率在固定方法（P = 0.085）、年龄（P = 0.329）或切除长度（P = 0.61）方面没有差异。在18例（26%）患者中发现了髋臼软骨溶解，（>= 20 cm）显示髋臼磨损风险趋势（P = 0.132）。股骨近端切除和使用组配式双极型假体重建的结果是可以接受的，感染和局部复发是短期并发症，松动和髋臼侵蚀是长期并发症。长期并发症。
Introduction: The proximal femur is a common site for primary sarcomas and metastatic lesions. Although the early results of tumor prostheses are promising, the long-term results of reconstruction are unknown. The purpose of this study is to evaluate the prognostic factors affecting prosthesis survival and complications after proximal femoral resection and reconstruction.Methods: We reviewed the results of 68 patients who underwent proximal femoral resection and reconstruction with a modular bipolar-type tumor prosthesis between 2005 and 2017. The mean follow-up was 55.6 months (range 6-172 months). There were 50 male and 18 female patients with a mean age of 41.5 years (range 11-80 years). Cumulative survival analysis was performed to analyze the risk factors of prosthesis survival. We also evaluated the complications after operation.Results: Fourteen (21%) patients required further surgery at a mean 37 months post-operatively (range 5-125 months). There were three cases of infection (4%), six of local recurrence (9%), three of acetabular erosion (4%) and two of stem loosening (3%). The implant survival rates were 83.9% at 5 years and 59.8% at 10 years. Prosthesis survivals did not differ based on fixation method (P = 0.085), age (P = 0.329) or resection length (P = 0.61). Acetabular chondrolysis was identified in 18 (26%) patients and longer resection length (>= 20 cm) showed a trend for risk of acetabular wear (P = 0.132).Conclusion: The results of proximal femoral resection and reconstruction with a modular bipolar-type prosthesis were found to be acceptable with infection and local recurrence as short-term complications and loosening and acetabular erosion as long-term complications.