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经改良前路空心钉 Harrington 手术治疗累及髋臼转移瘤和血液系统疾病的长期疗效。

The long-term outcomes of modified Harrington procedure using antegrade pins for periacetabular metastasis and haematological diseases.

机构信息

Royal Orthopaedic Hospital, Birmingham, UK.

University Hospital Ayr, Ayr, UK.

出版信息

Bone Joint J. 2019 Dec;101-B(12):1557-1562. doi: 10.1302/0301-620X.101B12.BJJ-2019-0265.R1.

Abstract

AIMS

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.

PATIENTS AND METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

患者与方法

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)。

结果

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。

结论

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。

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