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用于骨盆肿瘤切除的定制植入物。

Patient-Specific Implants for Pelvic Tumor Resections.

作者信息

Döring Kevin, Staats Kevin, Puchner Stephan, Windhager Reinhard

机构信息

Division of Orthopaedics, Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

J Pers Med. 2021 Jul 21;11(8):683. doi: 10.3390/jpm11080683.

Abstract

Introduction Limb salvage surgery for periacetabular malignancies is technically demanding and associated with a considerable likelihood of postoperative complications and surgical revision. Reconstruction using custom-made implants represents the treatment of choice. This study was conducted to analyze treatment outcomes of custom-made implants in a single orthopaedic tumor center. Patients and Methods Twenty patients with a histologically verified periacetabular malignancy and a median follow up time of 5 (1-17) years were included. Results The median number of revision surgeries per patient was 1.5 (0-7). Complications were dislocations in 3 patients, aseptic loosening in 4 patients, deep infections in 9 patients, thromboembolic events in 5 patients and sciatic nerve lesions in 4 patients. Overall survival was 77% after one year, 69% after two years and 46% after five years. Median Harris Hip Score was 81 (37-92) points at last follow up. Conclusion Although internal hemipelvectomy and reconstruction using custom-made implants is linked with a high risk of postoperative complications, good functional outcomes can be regularly achieved. This information may help treating surgeons to find adequate indications, as eligible patients need to be critically selected and integrated into the decision-making process.

摘要

引言 髋臼周围恶性肿瘤的保肢手术技术要求高,术后并发症和手术翻修的可能性很大。使用定制植入物进行重建是首选的治疗方法。本研究旨在分析单个骨科肿瘤中心定制植入物的治疗效果。

患者与方法 纳入20例经组织学证实的髋臼周围恶性肿瘤患者,中位随访时间为5(1-17)年。

结果 每位患者的翻修手术中位数为1.5(0-7)次。并发症包括3例脱位、4例无菌性松动、9例深部感染、5例血栓栓塞事件和4例坐骨神经损伤。1年后总生存率为77%,2年后为69%,5年后为46%。末次随访时Harris髋关节评分中位数为81(37-92)分。

结论 尽管半骨盆切除术加定制植入物重建术后并发症风险高,但仍可经常获得良好的功能结果。这些信息可能有助于治疗外科医生找到合适的适应症,因为需要严格挑选合适的患者并将其纳入决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed8c/8399992/cc36a904eaaa/jpm-11-00683-g001.jpg

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