中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (30): 5551-5554.doi: 10.3969/j.issn.1673-8225.2010.30.011

• 人工假体 artificial prosthesis • 上一篇    下一篇

肿瘤型髋关节假体治疗股骨近端转移性肿瘤37例：同一机构1年病例回顾

陈  凯，梁文清，蔡郑东   

  1. 解放军第二军医大学长海医院骨科，上海市 200433
  • 出版日期:2010-07-23 发布日期:2010-07-23
  • 通讯作者: 蔡郑东，硕士，主任医师，博士生导师，解放军第二军医大学长海医院骨科，上海市 200433
  • 作者简介:陈 凯★，男，1983年生，江苏省启东市人，汉族，2008年解放军第二军医大学毕业，硕士，医师，主要从事骨关节、骨肿瘤等方面的研究。 ch_kai@163.com

Endoprosthetic proximal femoral replacement for 37 patients with proximal femoral metastatic tumor in one institute: Retrospective analysis within one year

Chen Kai, Liang Wen-qing, Cai Zheng-dong   

  1. Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai  200433, China
  • Online:2010-07-23 Published:2010-07-23
  • Contact: Cai Zheng-dong, Master, Chief physician, Doctoral supervisor, Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
  • About author:Chen Kai★, Master, Physician, Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China ch_kai@163.com

PDF

359

摘要：

背景：人工关节假体重建不依赖于骨的愈合而达到恢复关节功能、减轻疼痛、以及尽早地重塑关节稳定的作用。对于股骨近端的转移性肿瘤而言，人工关节假体重建可能是最好的外科治疗方式。
目的：分析肿瘤型髋关节假体置换治疗股骨近端转移性肿瘤的疗效。
方法：对37例股骨近端转移性肿瘤患者采取瘤段广泛切除+肿瘤型髋关节假体置换。其中20例患者因病理性骨折而进行人工关节置换，其余患者因髋部疼痛和行走困难，通过关节置换来切除转移性病灶。
结果与结论：术后存活时间2周~9年，平均11个月。术后2个月存活32例，术后1年存活14例，MSTS评分平均为21.68分，术后2年存活8例。37例患者中，出现1例深部感染，2例股骨假体松动，1例术后早期假体脱位，2例由于外展肌力不全出现行走步态异常，2例远期出现患肢短缩畸形，1例出现明显的异位骨化。结果表明对于股骨近端转移性肿瘤的患者，采用肿瘤性髋关节假体置换治疗可以尽快获得牢靠地固定，恢复患者患肢功能。

关键词: 股骨近端, 转移性肿瘤, 肿瘤型髋关节假体, 关节置换, 生物相容性

Abstract:

BACKGROUND: Artificial joint prosthesis reconstruction is independent to bone healing, but can restore joint function, relieve pain and rebuilt joint stability. For metastatic tumor proximal to femur, artificial joint prosthesis reconstruction is the best surgical treatment.
OBJECTIVE: To discuss the clinical outcome with endoprosthetic proximal femoral replacement for the patients with metastatic bone disease.
METHODS: A total of 37 cases of metastatic tumor in the proximal femur were treated by wide excision and endoprosthetic proximal femoral replacement, including 20 patients undergoing endoprosthetic reconstruction for pathologic fractures, and others for impending fractures indicated by complains of pain and problems with walking.
RESULTS AND CONCLUSION: The survival time was 2 weeks to 9 years with an average time of 11 months. A total of 32 patients survived for 2-month postoperatively, of them, 14 patients survived for 1 postoperative year. The MSTS function score was 21.68 at the first postoperative year. A total of 8 patients survived after 2 years postoperatively. Of 37 patients, 1 developed deep infection, 2 femoral prosthesis loosening, 1 prosthesis dislocation, 2 abnormal walking due to incomplete abductor strength, 2 limb crispation deformity, and 1 heterotopic ossification. In patients with metastatic disease in the proximal femur, endoprosthetic reconstruction can provide early and stable fixation, remove metastasis with pain reduction and good functional results.

中图分类号: