Royal Orthopaedic Hospital, Birmingham, UK.
University Hospital Ayr, Ayr, UK.
Bone Joint J. 2019 Dec;101-B(12):1557-1562. doi: 10.1302/0301-620X.101B12.BJJ-2019-0265.R1.
The aim of this study was to present the long-term surgical outcomes, complications, implant survival, and causes of implant failure in patients treated with the modified Harrington procedure using antegrade large diameter pins.
A cohort of 50 consecutive patients who underwent the modified Harrington procedure for periacetabular metastasis or haematological malignancy between January 1996 and April 2018 were studied. The median follow-up time for all survivors was 3.2 years (interquartile range 0.9 to 7.6 years).
The five-year overall survival rate was 33% for all the patients. However, implant survival rates were 100% and 46% at five and ten years, respectively. Eight patients survived beyond five years. There was no immediate perioperative mortality or complications. A total of 15 late complications occurred in 11 patients (22%). Five patients (10%) required further surgery to treat complications. The most frequent complication was pin breakage without evidence of acetabular loosening (6%). Two patients (4%) underwent revision for aseptic loosening at 6.5 and 8.9 years after surgery. Ambulatory status and pain level were improved in 83% and 89%, respectively.
The modified Harrington procedure for acetabular destruction has low complication rates, good functional outcome, and improved pain relief in selected patients Cite this article: 2019;101-B:1557-1562.
本研究旨在介绍采用前路大直径钉改良 Harrington 手术治疗髋臼转移瘤或血液恶性肿瘤患者的长期手术结果、并发症、种植体存活率和种植体失败的原因。
研究纳入了 1996 年 1 月至 2018 年 4 月期间采用改良 Harrington 手术治疗髋臼转移瘤或血液恶性肿瘤的 50 例连续患者。所有存活患者的中位随访时间为 3.2 年(四分位距 0.9-7.6 年)。
所有患者的 5 年总生存率为 33%。然而,种植体的 5 年和 10 年存活率分别为 100%和 46%。8 例患者存活时间超过 5 年。无围手术期即刻死亡或并发症。11 例患者(22%)共发生 15 例晚期并发症。5 例患者(10%)因并发症需要进一步手术治疗。最常见的并发症是钉断裂,无髋臼松动证据(6%)。2 例患者(4%)分别在术后 6.5 年和 8.9 年因无菌性松动行翻修手术。83%的患者的活动能力和 89%的患者的疼痛水平得到改善。
对于选择合适的患者,改良 Harrington 手术治疗髋臼破坏具有较低的并发症发生率、良好的功能结果和改善疼痛缓解。