Tan Linyun, Wang Yitian, Hu Xin, He Xuanhong, Du Guifeng, Wang Hao, Tang Xiaodi, Sun Minghao, Tu Chongqi, Min Li
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Oct 15;38(10):1269-1275. doi: 10.7507/1002-1892.202404018.
To review the repair and reconstruction methods for large segmental femoral proximal bone defects caused by tumors, and to explore their clinical application effects, advantages, and disadvantages, and future research directions.
A comprehensive search of Chinese and foreign databases was conducted to select basic and clinical research literature related to the repair and reconstruction of femoral proximal bone defects caused by tumors. The studies were classified and analyzed based on two main strategies: hip-preserving reconstruction and non-hip-preserving reconstruction.
In hip-preserving reconstruction, traditional methods such as allograft transplantation and vascularized autograft transplantation are common but have risks of poor bone integration and bone resorption. The clinical application of inactivated tumor segment reimplantation and distraction osteogenesis techniques is limited. In recent years, three-dimensional printing technology has become increasingly mature, with personalized prostheses and precise surgeries becoming development trends. Non-hip-preserving reconstruction primarily includes allograft prosthesis composite and total femoral replacement. The former focuses on improving the survival rate and bone integration efficiency of the allograft, while the latter requires the simultaneous reconstruction of hip and knee joint stability.
Significant progress has been made in repairing and reconstructing proximal femoral bone defects caused by tumors, but many challenges remain. The integration of three-dimensional printing technology and digital design offers potential for precise bone defect repair. Future efforts should focus on new concepts, technologies, and materials through multidisciplinary approaches to provide personalized and precise solutions, thereby improving patient quality of life.
回顾肿瘤所致股骨近端大段骨缺损的修复与重建方法,探讨其临床应用效果、优缺点及未来研究方向。
全面检索中外数据库,选取与肿瘤所致股骨近端骨缺损修复与重建相关的基础及临床研究文献。根据保留髋关节重建和非保留髋关节重建两种主要策略对研究进行分类分析。
在保留髋关节重建中,同种异体骨移植和带血管自体骨移植等传统方法较为常见,但存在骨整合不良和骨吸收的风险。灭活肿瘤段再植入和牵张成骨技术的临床应用有限。近年来,三维打印技术日益成熟,个性化假体和精准手术成为发展趋势。非保留髋关节重建主要包括同种异体骨假体复合物和全股骨置换。前者侧重于提高同种异体骨的存活率和骨整合效率,后者则需要同时重建髋关节和膝关节的稳定性。
肿瘤所致股骨近端骨缺损的修复与重建取得了显著进展,但仍存在诸多挑战。三维打印技术与数字设计的融合为精确修复骨缺损提供了潜力。未来应通过多学科方法专注于新的概念、技术和材料,以提供个性化和精准的解决方案,从而提高患者生活质量。