Picardo N E, Blunn G W, Shekkeris A S, Meswania J, Aston W J, Pollock R C, Skinner J A, Cannon S R, Briggs T W
Royal National Orthopaedic Hospital, Bone Tumour Unit, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
J Bone Joint Surg Br. 2012 Mar;94(3):425-30. doi: 10.1302/0301-620X.94B3.27738.
In skeletally immature patients, resection of bone tumours and reconstruction of the lower limb often results in leg-length discrepancy. The Stanmore non-invasive extendible endoprosthesis, which uses electromagnetic induction, allows post-operative lengthening without anaesthesia. Between 2002 and 2009, 55 children with a mean age of 11.4 years (5 to 16) underwent reconstruction with this prosthesis; ten patients (18.2%) died of disseminated disease and one child underwent amputation due to infection. We reviewed 44 patients after a mean follow-up of 41.2 months (22 to 104). The mean Musculoskeletal Tumor Society score was 24.7 (8 to 30) and the Toronto Extremity Salvage score was 92.3% (55.2% to 99.0%). There was no local recurrence of tumour. Complications developed in 16 patients (29.1%) and ten (18.2%) underwent revision. The mean length gained per patient was 38.6 mm (3.5 to 161.5), requiring a mean of 11.3 extensions (1 to 40), and ten component exchanges were performed in nine patients (16.4%) after attaining the maximum lengthening capacity of the implant. There were 11 patients (20%) who were skeletally mature at follow-up, ten of whom had equal leg lengths and nine had a full range of movement of the hip and knee. This is the largest reported series using non-invasive extendible endoprostheses after excision of primary bone tumours in skeletally immature patients. The technique produces a good functional outcome, with prevention of limb-length discrepancy at skeletal maturity.
在骨骼未成熟的患者中，切除骨肿瘤并重建下肢常导致肢体长度不等。采用电磁感应的斯坦莫尔非侵入性可延长假体可在无需麻醉的情况下进行术后延长。2002年至2009年期间，55名平均年龄为11.4岁（5至16岁）的儿童接受了该假体重建；10名患者（18.2%）死于播散性疾病，1名儿童因感染接受了截肢。我们对44名患者进行了平均41.2个月（22至104个月）的随访。肌肉骨骼肿瘤学会平均评分为24.7（8至30），多伦多肢体挽救评分92.3%（55.2%至99.0%）。无肿瘤局部复发。16名患者（29.1%）出现并发症，10名患者（18.2%）接受了翻修手术。每位患者平均延长长度为38.6毫米（3.5至161.5毫米），平均延长11.3次（1至40次），9名患者（16.4%）在达到植入物最大延长能力后进行了10次部件更换。随访时有11名患者（20%）骨骼成熟，其中10名患者双下肢等长，9名患者髋膝关节活动范围正常。这是报道的骨骼未成熟患者原发性骨肿瘤切除术后使用非侵入性可延长假体的最大系列病例。该技术功能效果良好，可防止骨骼成熟时出现肢体长度不等。
