Gosheger Georg, Gebert Carsten, Ahrens Helmut, Streitbuerger Arne, Winkelmann Winfried, Hardes Jendrik
Department of Orthopaedics, Universität Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany.
Clin Orthop Relat Res. 2006 Sep;450:164-71. doi: 10.1097/01.blo.0000223978.36831.39.
We assessed the clinical results and complications associated with a new endoprosthetic replacement system (Mutars) used in 250 patients with a malignant bone or soft tissue tumor. The key features of the system are its cementless, hexagonal-shaped stem (titanium alloy), the possibility of torsion adjustments in 5 degrees -increments, and the Trevira tube for soft tissue attachment. The mean age of the patients was 30.7 years, and the mean followup was 45 months. Prosthetic survival at 5 years was 89.7% for the upper extremity and 68.5% for the lower extremity. Prosthetic survival without any reoperation was 73.4% at 3 years postoperatively and 60.4% at 5 years postoperatively. Prosthetic failure was caused by deep infection in 12% (30 patients) of patients and aseptic loosening in 8% (20 patients) of patients. Stem fracture occurred in only 1.6% (four patients) of patients. Dislocation rates were reduced by using the Trevira tube. Limb survival was achieved in 82.6% to 93.1% of patients depending on the endoprosthetic replacement site, and functional results ranged between 63% to 83% according to the Tumor Society score. Our results suggest limb salvage with the Mutars endoprosthesis is successful with good functional results.
Therapeutic study, Level IV (case series).
我们评估了一种新型内置假体置换系统(Mutars)应用于250例恶性骨或软组织肿瘤患者的临床结果及并发症。该系统的关键特性包括其无骨水泥的六边形柄(钛合金)、可进行5度增量的扭转调整以及用于软组织附着的特丽纶管。患者的平均年龄为30.7岁,平均随访时间为45个月。上肢假体5年生存率为89.7%,下肢为68.5%。术后3年无再次手术的假体生存率为73.4%,术后5年为60.4%。假体失败的原因是12%(30例患者)发生深部感染,8%(20例患者)发生无菌性松动。仅1.6%(4例患者)发生柄部骨折。使用特丽纶管降低了脱位率。根据内置假体置换部位的不同,82.6%至93.1%的患者实现了肢体存活,根据肿瘤协会评分,功能结果在63%至83%之间。我们的结果表明,使用Mutars假体进行保肢手术是成功的,功能结果良好。
治疗性研究,IV级(病例系列)。