改良 Harrington 重建术治疗晚期髋臼周围转移性疾病。
Modified Harrington reconstruction for advanced periacetabular metastatic disease.
机构信息
Department of Orthopaedics, Los Angeles County-University of Southern California Medical Center, Los Angeles, California 90033, USA.
出版信息
J Surg Oncol. 2010 Feb 1;101(2):170-4. doi: 10.1002/jso.21440.
BACKGROUND/OBJECTIVES: Destructive metastatic lesions about the acetabulum result in pain and functional limitations. We assessed whether periacetabular reconstruction (PAR) improves quality of life by examining outcome measures of pain, function, and mobility.
METHODS
Thirty-seven patients with a mean follow-up of 23.6 months (range, 0.5-112 months) were retrospectively reviewed. All patients underwent modified Harrington reconstruction with periacetabular screws, cement, and total hip arthroplasty.
RESULTS
The mean preoperative MSTS score of 14 (47%, 14/30) improved to 20 (67%, 20/30) after the procedure. Thirty-five patients who were alive 1 month after the procedure were reviewed for outcome. Postoperatively, patients reported a significant improvement in pain (P < 0.0001), mobility (P < 0.0385), and function (P < 0.0186). Kaplan-Meier survivorship curves showed 59% implant- and 55% patient survival at 2 years; and 49% implant- and 39% patient survival at 5 years. Complications included infection (16%, 6/37) and instability (16%, 6/37).
CONCLUSIONS
Our experience with PAR has shown good results with improved postoperative functional scores. Implants will generally exceed life expectancy and are an option to restore quality of life.
背景/目的：髋臼周围破坏性转移病灶会导致疼痛和功能受限。我们通过检查疼痛、功能和活动能力的评估指标，来评估髋臼周围重建（PAR）是否能改善生活质量。
方法
回顾性分析了 37 例患者，平均随访 23.6 个月（0.5-112 个月）。所有患者均行改良 Harrington 重建术，采用髋臼螺钉、骨水泥和全髋关节置换术。
结果
术前 MSTS 评分为 14（47%，14/30），术后提高至 20（67%，20/30）。术后 1 个月，35 例存活患者进行了疗效评估。术后患者疼痛（P<0.0001）、活动能力（P<0.0385）和功能（P<0.0186）均有显著改善。Kaplan-Meier 生存曲线显示，2 年时的假体和患者生存率分别为 59%和 55%；5 年时的假体和患者生存率分别为 49%和 39%。并发症包括感染（16%，6/37）和不稳定（16%，6/37）。
结论
我们在 PAR 方面的经验表明，术后功能评分有了显著改善，且效果良好。假体的使用寿命通常会超过预期寿命，是恢复生活质量的一种选择。
Zotero 插件