The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
Tokyo University, Bunkyo, Tokyo, Japan.
Bone Joint J. 2019 Sep;101-B(9):1144-1150. doi: 10.1302/0301-620X.101B9.BJJ-2018-1333.R1.
The aim of this study was to report the results of custom-made endoprostheses with extracortical plates plus or minus a short, intramedullary stem aimed at preserving the physis after resection of bone sarcomas in children.
Between 2007 and 2017, 18 children aged less than 16 years old who underwent resection of bone sarcomas, leaving ≤ 5 cm of bone from the physis, and reconstruction with a custom-made endoprosthesis were reviewed. Median follow-up was 67 months (interquartile range 45 to 91). The tumours were located in the femur in 11 patients, proximal humerus in six, and proximal tibia in one.
The five-year overall survival rate was 78%. No patient developed local recurrence. The five-year implant survival rate was 79%. In all, 11 patients (61%) developed a complication. Seven patients (39%) required further surgery to treat the complications. Implant failures occurred in three patients (17%) including one patient with aseptic loosening and two patients with implant or periprosthetic fracture. The preserved physis continued to grow at mean 3.3 cm (0 to 14). The mean Musculoskeletal Society score was 88% (67% to 97%).
Custom-made endoprostheses that aim to preserve the physis are a safe and effective option for preserving physeal growth, limb length, and joint function with an acceptable rate of complications. Cite this article: 2019;101-B:1144-1150.
本研究旨在报告在儿童骨肿瘤切除术后，采用带皮质外板的定制假体加或不加短节段髓内干，以保留骺板的结果。
2007 年至 2017 年，我们对 18 例年龄小于 16 岁、骺板切除后残留骺板＜5cm、采用定制假体重建的儿童骨肿瘤患者进行了回顾性分析。中位随访时间为 67 个月（四分位距 45-91）。肿瘤位于股骨 11 例，肱骨近端 6 例，胫骨近端 1 例。
5 年总生存率为 78%。无局部复发。5 年假体生存率为 79%。共 11 例（61%）发生并发症。7 例（39%）需要进一步手术治疗并发症。3 例（17%）发生假体失败，包括 1 例无菌性松动和 2 例假体或假体周围骨折。保留的骺板继续生长，平均 3.3cm（0-14）。肌肉骨骼协会评分平均为 88%（67%-97%）。
旨在保留骺板的定制假体是一种安全有效的选择，可以保留骺板生长、肢体长度和关节功能，并发症发生率可接受。
Bone Joint J. 2019;101-B(11):1383-1389.
