Gerrand C H, Currie D, Grigoris P, Reid R, Hamblen D L
Department of Orthopaedic Surgery, Western Infirmary, Glasgow, UK.
Int Orthop. 1999;23(5):286-90. doi: 10.1007/s002640050373.
The survival of patients and implants, complications and functional outcome were reviewed in 25 consecutive femoral endoprosthetic reconstructions for treatment of primary bone sarcoma. The diagnosis was chondrosarcoma in 11, osteosarcoma in 10, MFH in 3 and Ewing's tumour in 1. Median follow up was 64 months (34 to 219) and median age at operation was 29 years (10 to 70). Twelve remained disease free at review. One had amputation for local recurrence and another was alive with metastases. 11 patients died at a median of 13 months (5 to 128); 8 from metastatic disease and 3 from other causes. Four implants were revised, at a median of 95 months (53 to 136); two for fractures of the stem and two for aseptic loosening. Three implants had radiological evidence of loosening at a median of 43 months (34 to 49). Fourteen patients had significant complications. The median functional score using the Musculoskeletal Tumour Society system was 68%. In our experience, prosthetic reconstruction of the femur does not compromise survival, although there is a significant complication rate.
对连续25例用于治疗原发性骨肉瘤的股骨假体置换术患者的生存情况、植入物情况、并发症及功能结果进行了回顾性研究。诊断为软骨肉瘤11例，骨肉瘤10例，恶性纤维组织细胞瘤3例，尤因肉瘤1例。中位随访时间为64个月（34至219个月），手术时的中位年龄为29岁（10至70岁）。复查时12例无疾病复发。1例因局部复发行截肢术，另1例有转移灶但仍存活。11例患者死亡，中位死亡时间为13个月（5至128个月）；8例死于转移性疾病，3例死于其他原因。4例植入物进行了翻修，中位翻修时间为95个月（53至136个月）；2例因假体柄骨折，2例因无菌性松动。3例植入物在中位时间43个月（34至49个月）时有影像学证据显示松动。14例患者出现严重并发症。采用肌肉骨骼肿瘤学会系统评估的中位功能评分为68%。根据我们的经验，股骨假体置换术虽并发症发生率较高，但不影响患者生存率。
