Heyberger Clémence, Auberger Guillaume, Babinet Antoine, Anract Philippe, Biau David J
Service de Chirurgie Orthopédique, Hôpital Cochin, Paris, France.
INSERM U1153, Paris, France.
J Knee Surg. 2018 Oct;31(9):822-826. doi: 10.1055/s-0037-1615298. Epub 2017 Dec 21.
We asked whether there would be any difference between primary and revision modern cemented fixed hinge megaprosthesis of the distal femur in function and activity-related outcomes following treatment of a bone tumor. An identical custom-made fixed hinge cemented megaprosthesis with a hydroxyapatite collar was used in all cases. The main outcomes were joint-specific function, disease-specific activity, and health-related quality of life. Implant survival was also evaluated. Patients in the revision group performed slightly better than patients in the primary group on disease-specific (Toronto Extremity Salvage Score, = 0.033; Musculoskeletal Tumor Society, = 0.072) and health-related outcomes (Short Form 36 [SF-36] physical component, = 0.085; SF-36 mental component, = 0.069) but not on joint-specific outcomes (Knee Society Score, = 0.94). The cumulative probabilities of revision for any reason were 14.5% (7-25%) at 5 years with no statistically significant difference between primary and revision procedures ( = 0.77). In conclusion, patients undergoing a revision have similar joint-specific functional outcome but improved disease-specific and health-related outcomes. Implant survival are similar between groups.
我们探讨了在骨肿瘤治疗后，初次和翻修的现代骨水泥固定铰链型股骨远端假体在功能及与活动相关的结局方面是否存在差异。所有病例均使用了相同的定制带羟基磷灰石环的骨水泥固定铰链型假体。主要结局指标为关节特异性功能、疾病特异性活动及健康相关生活质量。同时也评估了植入物的生存率。翻修组患者在疾病特异性（多伦多肢体挽救评分，P = 0.033；肌肉骨骼肿瘤学会评分，P = 0.072）和健康相关结局（简明健康状况调查量表36项 [SF-36] 身体维度，P = 0.085；SF-36精神维度，P = 0.069）方面的表现略优于初次组，但在关节特异性结局（膝关节协会评分，P = 0.94）方面并非如此。5年时因任何原因进行翻修的累积概率为14.5%（7%-25%），初次手术和翻修手术之间无统计学显著差异（P = 0.77）。总之，接受翻修手术的患者关节特异性功能结局相似，但疾病特异性和健康相关结局有所改善。两组间植入物生存率相似。
