Zhao Jiazheng, Ma Xiaowei, Feng Helin
Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
J Bone Oncol. 2023 Feb 28;39:100473. doi: 10.1016/j.jbo.2023.100473. eCollection 2023 Apr.
Proximal femoral replacement (PFR) for oncology patients is gaining interest as a limb salvage operation due to its obvious advantages. However, almost all hip replacement surgeries including PFR, are faced with the challenge of how to reconstruct the functional musculature in an optimal way. To address the challenge, we have developed an innovative eggshell procedure and through this study we aim to investigate the specific efficacy of the procedure.
A total of 44 tumor patients with PFR surgery were incorporated into the study, including 12 who underwent the eggshell procedure and 32 who did not. General characteristics, short-term indicators, long-term indicators and complication outcomes were compared successively between the two groups of patients.
No significant differences were identified in general characteristics between the two groups. Overall, in terms of both short-term and long-term indicators, the patients with eggshell procedure performed significantly superior to the patients without it. Moreover, the eggshell procedure significantly reduced the incidence of associated complications, including prosthesis dislocation and hip pain.
Our eggshell procedure is convenient and accessible. On the one hand, it can reduce surgical side injuries without adding additional complications, and on the other it allows to improve joint mobility and life quality while diminishing the incidence of prosthesis dislocation and hip pain. Despite it may still remain limitations, we have reasons to believe that this procedure can be further promoted and applied.
由于近端股骨置换术（PFR）具有明显优势，作为一种保肢手术，它在肿瘤患者中越来越受到关注。然而，几乎所有的髋关节置换手术，包括PFR，都面临着如何以最佳方式重建功能性肌肉组织的挑战。为应对这一挑战，我们开发了一种创新的蛋壳手术方法，通过本研究，我们旨在探讨该手术方法的具体疗效。
本研究共纳入44例行PFR手术的肿瘤患者，其中12例接受了蛋壳手术，32例未接受。对两组患者的一般特征、短期指标、长期指标和并发症结果进行了相继比较。
两组患者的一般特征无显著差异。总体而言，在短期和长期指标方面，接受蛋壳手术的患者表现明显优于未接受该手术的患者。此外，蛋壳手术显著降低了相关并发症的发生率，包括假体脱位和髋关节疼痛。
我们的蛋壳手术方法简便易行。一方面，它可以减少手术侧损伤，且不增加额外并发症；另一方面，它可以改善关节活动度和生活质量，同时降低假体脱位和髋关节疼痛的发生率。尽管它可能仍存在局限性，但我们有理由相信该手术方法可以进一步推广应用。
