Pu Feifei, Yu Yihan, Shao Zengwu, Wu Wei, Feng Jing, Chen Fengxia, Zhang Zhicai
Department of Orthopedics, Wuhan Hospital of Traditional Chinese and Western Medicine (Wuhan No.1 Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Departments of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Front Oncol. 2023 Apr 6;13:1115898. doi: 10.3389/fonc.2023.1115898. eCollection 2023.
To examine clinical outcomes of a specialized modular prosthesis used to fill a bone deficiency following removal of femoral shaft metastases.
Eighteen patients with femoral shaft metastases who underwent en bloc resection and implantation of a personalized modular prosthesis between December 2014 and December 2019 were retrospectively analyzed. Pain, limb function, and quality of life were evaluated using the visual analog scale (VAS), Musculoskeletal Tumor Society (MSTS) scale, International Society of Limb Salvage (ISOLS) scoring system, Karnofsky Performance Status (KPS) scale, and Nottingham Health Profile (NHP) scale. The Kaplan-Meier technique was used to analyze patient survival.
The operation duration was 90-150 min (mean, 115 min), and the osteotomy length was 9-16 cm (mean, 11.72 cm). The patients were followed for 12-62 months (mean, 25.28 months). The VAS and NHP ratings were lower at 3, 6, and 12 months after surgery than before surgery, while the MSTS, ISOLS, and KPS scores were higher after surgery than they had been before. These differences were statistically significant (<0.05). The survival period was between 7 and 62 months (mean, 20.89 months), and the rates of survival at 1-year and 2-year were 72.22% and 27.78%, respectively. Except for two patients with aseptic prosthesis loosening during the follow-up period, there were no problems.
En bloc excision and implantation of a personalized modular prosthesis can reduce pain and improve the ability of patients with femoral shaft metastases to perform daily activities, thereby improving their quality of life.
研究一种用于填充股骨干转移瘤切除术后骨缺损的特制模块化假体的临床疗效。
回顾性分析2014年12月至2019年12月期间接受整块切除并植入个性化模块化假体的18例股骨干转移瘤患者。采用视觉模拟量表（VAS）、肌肉骨骼肿瘤学会（MSTS）量表、肢体挽救国际协会（ISOLS）评分系统、卡氏功能状态（KPS）量表和诺丁汉健康概况（NHP）量表评估疼痛、肢体功能和生活质量。采用Kaplan-Meier技术分析患者生存率。
手术时间为90 - 150分钟（平均115分钟），截骨长度为9 - 16厘米（平均11.72厘米）。患者随访12 - 62个月（平均25.28个月）。术后3个月、6个月和12个月时的VAS和NHP评分低于术前，而术后MSTS、ISOLS和KPS评分高于术前。这些差异具有统计学意义（<0.05）。生存期为7至62个月（平均20.89个月），1年和2年生存率分别为72.22%和27.78%。除两名患者在随访期间出现无菌性假体松动外，未出现其他问题。
整块切除并植入个性化模块化假体可减轻股骨干转移瘤患者的疼痛，提高其日常活动能力，从而改善生活质量。
