Flint Michael N, Griffin Anthony M, Bell Robert S, Wunder Jay S, Ferguson Peter C
Orthopaedic Oncology Unit, Middlemore Hospital, Auckland, New Zealand.
J Arthroplasty. 2007 Sep;22(6):859-65. doi: 10.1016/j.arth.2006.11.003.
We reviewed our experience with 2-stage revision of uncemented Kotz Modular Femoral and Tibial Replacement System prostheses from 1989 to 2004. A total of 180 lower extremity tumor prostheses were inserted, 15 of which underwent removal of the prosthesis for infection. Eleven patients underwent subsequent second-stage revision, and 4 underwent amputation. Of the 11 patients who underwent revision, 8 continue to be free of infection an average of 33 months postoperatively. Of these 8 patients, 6 were revised without removal of the diaphyseal anchorage piece, which were all well ingrown. Most successful revisions were in the group that developed infection within 6 months of their original procedure. Two-stage revision of uncemented tumor endoprostheses with retention of a well-ingrown stem can be associated with successful eradication of infection.
我们回顾了1989年至2004年期间对非骨水泥型Kotz模块化股骨和胫骨置换系统假体进行二期翻修的经验。共植入了180个下肢肿瘤假体，其中15个因感染而进行了假体取出。11例患者随后接受了二期翻修，4例接受了截肢。在接受翻修的11例患者中，8例术后平均33个月仍无感染。在这8例患者中，6例翻修时未取出骨干固定件，这些固定件均已牢固长入。大多数成功的翻修发生在初次手术后6个月内发生感染的患者组中。保留牢固长入的柄部对非骨水泥型肿瘤假体进行二期翻修可能与成功根除感染有关。
