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[髋臼周围恶性肿瘤切除术后模块化人工关节假体置换的疗效]

[Efficacy of reconstruction with modular endoprosthesis after resection of periacetabular malignant tumors].

作者信息

Guo Xiaoning, Liu Tang, Li Xiaoyang, Li Zhihong, Peng Dan, Zhang Xiangsheng, Zhang Qing

机构信息

Department of Orthopaedics, Second Xiangya Hospital, Central South University, Changsha 410011, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Sep 28;41(9):962-8. doi: 10.11817/j.issn.1672-7347.2016.09.011.

Abstract

OBJECTIVE

To explore the efficacy of the resection of periacetabular malignant tumors and the reconstruction with modular endoprosthesis.

METHODS

From August 2006 to December 2012, 22 patients with periacetabular malignant tumors, who received the resection and reconstruction with modular prosthesis, were retrospectively reviewed. There were 11 males and 11 females, and the average age was 44 (16-65) years old. Pathological results showed there were 13 cases of chondrosarcoma, 5 cases of osteosarcoma, 2 cases of Ewing's sarcoma, 1 case of maligant fibrous histiocytoma, and 1 case of giant cell tumor. According to the classification system by Enneking, there were 11 cases of Type II+III resection, 5 cases of Type I+II+III resection, 3 cases of Type I+II resection, and 3 cases of Type II resection.

RESULTS

All patients were followed up. The average time for follow-up was 49 (11-103) months. At the last time of follow-up, 13 patients (59%) were still alive, 9 patients (41%) died due to their primary disease. Metastasis occurred in 8 patients (36%), and local recurrence occurred in 5 patients (23%). The mean Musculoskeletal Tumor Society (MSTS) score for 13 cases of alive patients at the latest time of follow-up was (18.5±5.7) months. The mean score for 11 patients, whose limb salvage were successful, was 20.7±2.0.

CONCLUSION

Reconstruction with modular prosthesis after wide resection for periacetabular malignant tumor can achieve satisfied outcome.

摘要

目的

探讨髋臼周围恶性肿瘤切除及模块化人工关节置换重建的疗效。

方法

回顾性分析2006年8月至2012年12月间22例行模块化人工关节置换切除重建术的髋臼周围恶性肿瘤患者资料。男11例,女11例,平均年龄44(16 - 65)岁。病理结果显示:软骨肉瘤13例,骨肉瘤5例,尤因肉瘤2例,恶性纤维组织细胞瘤1例,骨巨细胞瘤1例。按Enneking分期系统:Ⅱ+Ⅲ型切除11例,Ⅰ+Ⅱ+Ⅲ型切除5例,Ⅰ+Ⅱ型切除3例,Ⅱ型切除3例。

结果

所有患者均获随访,平均随访时间49(11 - 103)个月。末次随访时,存活13例(59%),9例(41%)因原发病死亡。发生转移8例(36%),局部复发5例(23%)。13例存活患者末次随访时肌肉骨骼肿瘤学会(MSTS)平均评分为(18.5±5.7)分。11例保肢成功患者平均评分为20.7±2.0分。

结论

髋臼周围恶性肿瘤广泛切除后行模块化人工关节置换重建可获满意疗效。

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