Hu Y-C, Huang H-C, Lun D-X, Wang H
Departments of Orthopaedic Oncology, Tianjin Hospital, 406 Jiefangnan Road, Hexi District, Tianjin 300211, People's Republic of China.
Eur J Surg Oncol. 2012 Aug;38(8):692-9. doi: 10.1016/j.ejso.2012.04.014. Epub 2012 May 24.
Surgical treatment of periacetabular tumors remains one of the most challenging problems in musculoskeletal oncology. The purpose of this study was to review the clinical and functional outcomes of resection hip arthroplasty and analyze its feasibility.
This study assesses twenty-seven patients with periacetabular tumors treated by resection hip arthroplasty between 1999 and 2010. The tumors were excised with wide margins and the residual intact femoral head placed underneath the resected ilium. Clinical, functional and oncological outcomes as well as complications were carefully evaluated.
The average follow-up time was 55 months (range, 3-118) and the mean surgical time 170 min (range, 120-350) with an average blood loss 1200 ml (range, 600-2200). Six patients died in 6-33 months postoperatively; no other local recurrences or deaths occurred. The 1-year, 5-year, and 10-year disease-free survival rates were 96.3%, 77.8% and 77.8% respectively. The mean limb-length discrepancy was 5 cm (range, 2-7.5) and all patients required custom-made shoes with their heels heightened by 2-5 cm. At the last follow-up, the mean functional score was 75.6%. Twenty patients recovered normal ambulation function with custom-made shoes and seven had to walk with crutches. Wound healing problems were observed in nine patients and deep or superficial infection in none.
Resection hip arthroplasty is recommended as a feasible surgical protocol for periacetabular tumors because it has few complications, good functional results, short surgical time and little blood loss.
髋臼周围肿瘤的外科治疗仍是肌肉骨骼肿瘤学中最具挑战性的问题之一。本研究的目的是回顾切除髋关节置换术的临床和功能结果，并分析其可行性。
本研究评估了1999年至2010年间接受切除髋关节置换术治疗的27例髋臼周围肿瘤患者。肿瘤被广泛切除，残留的完整股骨头置于切除的髂骨下方。仔细评估临床、功能和肿瘤学结果以及并发症。
平均随访时间为55个月（范围3 - 118个月），平均手术时间为170分钟（范围120 - 350分钟），平均失血量为1200毫升（范围600 - 2200毫升）。6例患者在术后6 - 33个月死亡；未发生其他局部复发或死亡。1年、5年和10年无病生存率分别为96.3%、77.8%和77.8%。平均肢体长度差异为5厘米（范围2 - 7.5厘米），所有患者均需要定制鞋跟垫高2 - 5厘米的鞋子。在最后一次随访时，平均功能评分为75.6%。20例患者通过定制鞋恢复了正常行走功能，7例患者不得不使用拐杖行走。9例患者出现伤口愈合问题，无一例出现深部或浅表感染。
切除髋关节置换术被推荐为髋臼周围肿瘤可行的手术方案，因为它并发症少、功能结果良好、手术时间短且失血量少。
