Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China.
The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China.
J Orthop Surg Res. 2021 Feb 8;16(1):119. doi: 10.1186/s13018-021-02275-y.
Although researchers have adopted various methods for the resection and reconstruction of periacetabular tumors, the total incidence rate of complications remains high. Aiming for preserving the acetabulum and reducing the risk of complications, we applied a surgery method using tumor-free autologous femoral head to reconstruct the defective acetabulum after resection of periacetabular tumors followed by performing a conventional total hip arthroplasty (THA). Moreover, we proposed a preliminary classification system for these surgery methods.
We retrospectively reviewed 6 patients treated with acetabulum reconstruction combined with autologous femoral head following peri-acetabulum resection between April 2010 and May 2018. All patients were diagnosed as periacetabular tumors including chondrosarcoma (n = 5) and chondroblastoma (n = 1). Clinical data such as age, diagnosis, complications, local recurrence or metastasis, and function (Musculoskeletal Tumor Society 1993, MSTS93) were documented. The average time of follow-up was 62.5 months (range, 17 to 106 months).
A total of 5 patients survive with average MSTS93 score of 27.8 points (range, 26-30). One patient, suffering from multiple bone metastasis prior treatment, ended up dying. One who had received radiotherapy before surgery had poor incision healing. Further, a classification system was preliminary proposed in 2 patients involving the pubis (type A) and 4 patients involving ischium (type B).
Based on the results, we preliminary proposed a classification system for reconstruction with autologous femoral head after periacetabular low malignant tumors resection. The clinical results suggested that surgery methods involving pubis (type A) and ischium (Type B) are safe and feasible. However, further researches should be conducted to verify our classification system.
尽管研究人员已经采用了各种方法来切除和重建髋臼周围肿瘤，但并发症的总发生率仍然很高。为了保留髋臼并降低并发症的风险，我们应用了一种手术方法，即使用无肿瘤的自体股骨头来重建髋臼周围肿瘤切除后的髋臼缺损，然后进行常规的全髋关节置换术（THA）。此外，我们提出了一种初步的手术方法分类系统。
我们回顾性分析了 2010 年 4 月至 2018 年 5 月期间接受髋臼重建联合自体股骨头治疗的 6 例髋臼周围肿瘤患者。所有患者均被诊断为髋臼周围肿瘤，包括软骨肉瘤（n=5）和软骨母细胞瘤（n=1）。记录了年龄、诊断、并发症、局部复发或转移以及功能（肌肉骨骼肿瘤学会 1993 年，MSTS93）等临床资料。平均随访时间为 62.5 个月（范围，17 至 106 个月）。
共有 5 例患者存活，平均 MSTS93 评分为 27.8 分（范围，26-30）。1 例患者在治疗前有多发骨转移，最终死亡。1 例患者术前接受过放疗，切口愈合不良。进一步，我们在 2 例涉及耻骨（A型）和 4 例涉及坐骨（B 型）的患者中初步提出了一个分类系统。
根据结果，我们初步提出了一种髋臼周围低度恶性肿瘤切除后采用自体股骨头重建的分类系统。临床结果表明，涉及耻骨（A型）和坐骨（B 型）的手术方法是安全可行的。然而，需要进一步的研究来验证我们的分类系统。
