Duparc J, Huten D, Benfrech E
Clinique de Chirurgie orthopédique, Hôpital Bichat, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1989;75(1):1-10.
The lytic metastasis of the acetabulum are frequent, causing pathologic fractures, pain and disability. The authors analyze 42 acetabular metastases operated on between 1976 and 1986. Thirty-nine total hip replacements were made, 9 conventional arthroplasties for minor lesions, and 30 metallo-acrylic reconstructive surgery of the acetabulum combined in 8 cases to bone grafting of more extensive lesions. These arthroplasties allowed immediate weight-bearing. In three cases of very extensive acetabular destructions, hip resections were only possible. The complications were essentially: 3 early deaths, 2 acetabular loosening by tumor osteolysis, and one deep infection. Mean follow-up was 15 months. Results were assessed by pain and walking which are in the whole satisfactory in these patients with limited life expectancy. Surgical indications should be wide in disable patients. It is a palliative surgery aiming to improve the quality of life, giving the patient a functional autonomy.
髋臼的溶骨性转移很常见,会导致病理性骨折、疼痛和残疾。作者分析了1976年至1986年间接受手术治疗的42例髋臼转移瘤。共进行了39例全髋关节置换术,9例针对轻微病变的传统关节成形术,以及30例髋臼金属丙烯酸重建手术,其中8例联合更广泛病变的骨移植。这些关节成形术允许患者立即负重。在3例髋臼广泛破坏的病例中,仅可行髋关节切除术。主要并发症有:3例早期死亡,2例因肿瘤骨溶解导致髋臼松动,1例深部感染。平均随访时间为15个月。通过疼痛和行走情况评估结果,对于这些预期寿命有限的患者,总体结果令人满意。对于残疾患者,手术适应证应放宽。这是一种旨在提高生活质量、给予患者功能自主性的姑息性手术。