Jaiswal P K, Aston W J S, Grimer R J, Abudu A, Carter S, Blunn G, Briggs T W R, Cannon S
Institute of Orthopaedics, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
J Bone Joint Surg Br. 2008 Sep;90(9):1222-7. doi: 10.1302/0301-620X.90B9.20758.
We treated 98 patients with peri-acetabular tumours by resection and reconstruction with a custom-made pelvic endoprosthesis. The overall survival of the patients was 67% at five years, 54% at ten years and 51% at 30 years. One or more complications occurred in 58.1% of patients (54), of which infection was the most common, affecting 30% (28 patients). The rate of local recurrence was 31% (29 patients) after a mean follow-up of 71 months (11 to 147). Dislocation occurred in 20% of patients (19). Before 1996 the rate was 40.5% (17 patients) but this was reduced to 3.9% (two patients) with the introduction of a larger femoral head. There were six cases of palsy of the femoral nerve with recovery in only two. Revision or excision arthroplasty was performed in 23.7% of patients (22), principally for uncontrolled infection or aseptic loosening. Higher rates of death, infection and revision occurred in men. This method of treatment is still associated with high morbidity. Patients should be carefully selected and informed of this pre-operatively.
我们采用定制的骨盆内假体切除和重建术治疗了98例髋臼周围肿瘤患者。患者的5年总生存率为67%，10年为54%，30年为51%。58.1%（54例）的患者发生了一种或多种并发症，其中感染最为常见，占30%（28例患者）。平均随访71个月（11至147个月）后，局部复发率为31%（29例患者）。20%（19例）的患者发生了脱位。1996年前脱位率为40.5%（17例患者），但随着更大股骨头的引入，脱位率降至3.9%（2例患者）。有6例股神经麻痹，仅2例恢复。23.7%（22例）的患者接受了翻修或切除关节成形术，主要是针对无法控制的感染或无菌性松动。男性的死亡率、感染率和翻修率更高。这种治疗方法仍伴有较高的发病率。应仔细选择患者，并在术前告知他们这一情况。
