Klinik und Poliklinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Münster, Germany.
J Arthroplasty. 2011 Aug;26(5):744-50. doi: 10.1016/j.arth.2010.06.011. Epub 2010 Aug 8.
We reviewed outcomes and discussed surgical difficulties encountered in 10 patients who had modular endoprosthesis for limb preserving salvage of failed allograft reconstruction after malignant tumor resection. Mean allograft survival time before failure was 127.4 months (range, 14-264 months). Mean length of follow-up since endoprosthesis revision surgery was 62.8 months (range, 16-132 months). There was one endoprosthesis failure, resulting in a mean endoprosthesis survival time of 56.9 months (range, 16-132). Complications included arterial laceration, nerve injury, periprosthetic crack fracture, aseptic loosening, and infection. Modular endoprosthesis remain a viable option that should be considered in any limb preserving salvage of failed allograft reconstructions. However, altered anatomy, poor/short remnant host bone, periprosthetic fractures, inadequate soft tissue coverage and infection remain important difficulties encountered.
我们回顾了 10 例患者的结果，并讨论了他们在肢体保留性保肢 salvage 中遇到的手术困难，这些患者在恶性肿瘤切除后，采用模块化假体进行了异体移植物重建失败。异体移植物失效前的平均存活时间为 127.4 个月（范围，14-264 个月）。自假体翻修手术后的平均随访时间为 62.8 个月（范围，16-132 个月）。有 1 例假体失效，导致假体平均存活时间为 56.9 个月（范围，16-132）。并发症包括动脉撕裂、神经损伤、假体周围裂纹骨折、无菌性松动和感染。模块化假体仍然是一种可行的选择，应考虑用于任何肢体保留性保肢 salvage 中，以治疗异体移植物重建失败。然而，改变的解剖结构、较差/短的残余宿主骨、假体周围骨折、软组织覆盖不足和感染仍然是遇到的重要困难。
