Huffman Allison, Schneeberger Steven, Goodyear Evelyn, West Julie M, O'Brien Andrew L, Scharschmidt Thomas J, Mayerson Joel L, Schulz Steven A, Moore Amy M
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Orthopaedic Surgery, The Ohio State University James Wexner Medical Center, Columbus, OH, USA.
J Orthop. 2022 Apr 19;31:117-120. doi: 10.1016/j.jor.2022.04.008. eCollection 2022 May-Jun.
Hip disarticulations are proximal lower extremity amputations with high postoperative complication and mortality rates. The purpose of the study was to evaluate hip disarticulation outcomes at our institution. Targeted Muscle Reinnervation (TMR) is an effective surgical technique shown to reduce pain in amputees. A secondary goal of the study was to evaluate the impact of implementing TMR on this patient population.
A retrospective review was performed for patients who underwent hip disarticulation with and without TMR between 2009 and 2020. Information on one-year mortality, thirty-day complication rates, operation times, surgical charges, and pain scores was collected.
Fifty-one patients underwent hip disarticulation, eight of which had TMR performed at the time of their hip disarticulation. The one-year mortality rate was 37% with 30-day infection, readmission, reoperation, and rates of 37%, 39%, and 27% respectively. The thirty-day major complication rate was 47% overall but not statistically significantly different between groups. There were no differences between groups with regard to 30-day readmission, reoperation, and infection rates.
Our results represent one of the largest series of hip disarticulation outcomes. Performing TMR at the time of hip disarticulation did not negatively affect outcomes and may be a beneficial adjunct to improve pain. Further research is warranted.
髋关节离断术是下肢近端截肢手术，术后并发症和死亡率较高。本研究的目的是评估我院髋关节离断术的治疗效果。靶向肌肉再支配（TMR）是一种有效的外科技术，已被证明可减轻截肢患者的疼痛。本研究的第二个目标是评估实施TMR对该患者群体的影响。
对2009年至2020年间接受或未接受TMR的髋关节离断术患者进行回顾性研究。收集了有关一年死亡率、30天并发症发生率、手术时间、手术费用和疼痛评分的信息。
51例患者接受了髋关节离断术，其中8例在髋关节离断术时进行了TMR。一年死亡率为37%，30天感染、再入院和再次手术率分别为37%、39%和27%。30天主要并发症发生率总体为47%，但两组之间无统计学显著差异。两组在30天再入院、再次手术和感染率方面无差异。
我们的结果代表了最大规模的髋关节离断术治疗效果系列之一。在髋关节离断术时进行TMR不会对治疗效果产生负面影响，可能是改善疼痛的有益辅助手段。有必要进行进一步研究。
