Ritschl P, Capanna R, Helwig U, Campanacci M, Kotz R
Orthopädische Universitätsklinik Wien.
Z Orthop Ihre Grenzgeb. 1992 Jul-Aug;130(4):290-3. doi: 10.1055/s-2008-1039620.
206 patients with tumorendoprosteses of the KMFTR-type at the lower extremity were operated at the Institute Rizolli Bologna and at the University Clinic of Vienna. The minimum follow up was 2 years (mean 3.2, max. 8 years). In order to bridge the defect caused by tumor resection the proximal femur was replaced in 42 cases, the distal femur in 119 cases and in 6 patients a total femur prosthesis was used. The proximal tibia was replaced in 35 cases and in 4 cases a total knee prosthesis was implanted. Clinical evaluation according to Enneking revealed 71.6% excellent and good results. In 83.4% the radiological score was higher then 20. We saw deep infections in 8.2% (17 patients), breakage of the prosthesis in 6.8% and aseptic loosening in 5.8%. 3 patients had to be amputated due to infection. In the remaining cases of infection in 66% of the patients healing was observed. All cases of aseptic loosening or breakage could be revised successfully by an exchange of the prostheses and therefore salvage of the leg was achieved.
206例下肢KMFTR型肿瘤假体患者在博洛尼亚里佐利研究所和维也纳大学诊所接受了手术。最短随访时间为2年(平均3.2年,最长8年)。为了填补肿瘤切除造成的缺损,42例患者置换了股骨近端,119例患者置换了股骨远端,6例患者使用了全股骨假体。35例患者置换了胫骨近端,4例患者植入了全膝关节假体。根据恩内金标准进行的临床评估显示,优良率为71.6%。83.4%的患者放射学评分高于20分。我们观察到深部感染发生率为8.2%(17例患者),假体断裂发生率为6.8%,无菌性松动发生率为5.8%。3例患者因感染不得不截肢。在其余感染病例中,66%的患者实现了愈合。所有无菌性松动或断裂病例均可通过更换假体成功翻修,从而保住了下肢。