Calabró Teresa, Van Rooyen Rupert, Piraino Ilaria, Pala Elisa, Trovarelli Giulia, Panagopoulos Georgios N, Megaloikonomos Panayiotis D, Angelini Andrea, Mavrogenis Andreas F, Ruggieri Pietro
Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
First Department of Orthopaedics, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece.
Eur J Orthop Surg Traumatol. 2016 May;26(4):415-21. doi: 10.1007/s00590-016-1764-0. Epub 2016 Apr 4.
Various megaprostheses are currently available for reconstruction of the proximal femur after tumor resection. This study evaluates the survival and complications of a modular megaprosthesis for reconstruction of the proximal femur.
We studied the medical files of 109 tumor patients (age range 16-86 years) who underwent proximal femoral reconstruction with the MRP(®) megaprosthesis from 2002 to 2011. There were 70 patients with metastases, 34 patients with bone sarcomas, and five patients with hematological malignancies; 82 were primary and 27 were revision reconstructions. Mean follow-up was 2.5 years; 31 patients had a minimum five-year follow-up. We evaluated the survival and function of the patients, and the survival and complications of the megaprostheses.
Survival was significantly higher for the patients with bone sarcomas compared to those with metastases and hematological malignancies. Mean MSTS functional score was similar between patients with bone sarcomas and those with hematological malignancies and metastases, and between patients with primary and those with revision reconstructions. Overall survival of the MRP(®) megaprostheses was 74 % at 5 and 9 years. Fourteen (13.6 %) major complications occurred at a mean period of 1.4 years (range 3 months to 4.5 years); these included infection (5.8 %), dislocation (3.9 %), local recurrence (2.9 %), and acetabular fracture (1 %).
MRP(®) megaprostheses are a valuable reconstruction option after tumor resection of the proximal femur.
目前有多种大型假体可用于肿瘤切除后股骨近端的重建。本研究评估用于股骨近端重建的模块化大型假体的生存率及并发症情况。
我们研究了2002年至2011年间109例接受MRP（®）大型假体股骨近端重建的肿瘤患者（年龄范围16 - 86岁）的病历。其中有70例转移瘤患者、34例骨肉瘤患者和5例血液系统恶性肿瘤患者；82例为初次重建，27例为翻修重建。平均随访时间为2.5年；31例患者至少随访了5年。我们评估了患者的生存率和功能，以及大型假体的生存率和并发症情况。
骨肉瘤患者的生存率显著高于转移瘤和血液系统恶性肿瘤患者。骨肉瘤患者与血液系统恶性肿瘤和转移瘤患者之间，以及初次重建患者与翻修重建患者之间的平均肌肉骨骼肿瘤协会（MSTS）功能评分相似。MRP（®）大型假体在5年和9年时的总体生存率为74%。14例（13.6%）主要并发症发生的平均时间为1.4年（范围3个月至4.5年）；这些并发症包括感染（5.8%）、脱位（3.9%）、局部复发（2.9%）和髋臼骨折（1%）。
MRP（®）大型假体是股骨近端肿瘤切除后一种有价值的重建选择。
