Kim Han-Soo, Kim Kap-Jung, Han Ilkyu, Oh Joo Han, Lee Sang-Hoon
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Clin Orthop Relat Res. 2007 Nov;464:217-23. doi: 10.1097/BLO.0b013e3181583ae4.
Reconstruction after periacetabular resection is a challenge. We asked whether the use of pasteurized autologous grafts would provide satisfactory results regarding patient survival, local recurrence, and metastasis, and graft union and functional outcome. We retrospectively reviewed 11 patients having such grafts with a minimum followup of 12 months (mean, 40 months; range, 12-116 months). All patients underwent periacetabular (Type II) resection of malignant periacetabular tumors. The resected bone was treated in saline at 65 degrees C for 30 minutes and reimplanted into the host bone with internal fixation. Total hip arthroplasty was performed in all patients. Local recurrence occurred in two of nine patients with primary sarcoma. Ten grafts survived at the last followup. Union of the resected bone with the host bone was achieved in eight of the 11 patients at an average of 12 months. The overall functional rating was 61% according to the Musculoskeletal Tumor Society System, with better results in the patients with primary tumors. Graft fracture (one patient) and infection (one patient) were the major complications. Our data suggest the use of pasteurization may be a reasonable option for reconstruction after resection of malignant periacetabular tumors.
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
髋臼周围切除术后的重建是一项挑战。我们探讨了使用经巴氏消毒的自体移植物在患者生存率、局部复发、转移以及移植物愈合和功能结果方面是否能提供满意的结果。我们回顾性分析了11例行此类移植物手术的患者，其最短随访时间为12个月（平均40个月；范围12 - 116个月）。所有患者均接受了髋臼周围（II型）恶性髋臼周围肿瘤切除术。切除的骨块在65摄氏度的盐水中处理30分钟，然后内固定再植入宿主骨。所有患者均行全髋关节置换术。9例原发性肉瘤患者中有2例发生局部复发。在最后一次随访时，10块移植物存活。11例患者中有8例切除的骨块与宿主骨愈合，平均愈合时间为12个月。根据肌肉骨骼肿瘤学会系统，总体功能评分为61%，原发性肿瘤患者结果更好。移植物骨折（1例患者）和感染（1例患者）是主要并发症。我们的数据表明，巴氏消毒法可能是恶性髋臼周围肿瘤切除术后重建的一个合理选择。
IV级，治疗性研究。有关证据水平的完整描述，请参阅作者指南。
