Orthopaedics Unit, Policlinico Universitario di Bari, Department of Translational Biomedicine and Neuroscience 'DiBraiN', University of Bari "Aldo Moro", Piazza G. Cesare 11, 70124 Bari, Italy.
Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Curr Oncol. 2024 Nov 15;31(11):7190-7203. doi: 10.3390/curroncol31110531.
With the advancements in chemotherapy for malignant bone tumors, the number of patients eligible for limb salvage surgery has increased. Surgeons face a subsequent challenge in limb-sparing resection due to the need for reconstructing soft tissue coverage. The aim of this review is to focus on the present state of the field in these areas, highlighting recent advancements.
A literature research was conducted using keywords such as "soft tissue", "integration", "reconstruction", "megaprosthesis", and "soft tissue coverage", on different databases, and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria, a total of 35 studies were selected.
In recent times, there has been a growing emphasis on different techniques such mesh application, allograft-prosthesis composites, allograft reconstruction, a polyethylene terephthalate (PET) tube, prosthesis itself and certain metals utilized for implant coatings are used in soft tissue reconstruction.
While tissue-engineered constructs and advancements in biological and cellular approaches have shown potential for enhancing osseointegration and interactions with soft tissues and implants, the actual clinical outcomes have frequently fallen short of expectations. The success of soft tissue integration is crucial for achieving functional outcomes, minimizing complications, and ensuring the long-term stability of orthopedic implants.
随着恶性骨肿瘤化疗的进步,适合保肢手术的患者数量有所增加。由于需要重建软组织覆盖,因此,外科医生在进行保肢切除时面临着后续的挑战。本文的目的是关注这些领域的当前现状,强调最近的进展。
使用“软组织”、“整合”、“重建”、“假体”和“软组织覆盖”等关键词,在不同的数据库中进行文献研究,并遵循系统评价和荟萃分析的首选报告项目(PRISMA)标准,共选择了 35 项研究。
最近,人们越来越关注不同的技术,例如网状物的应用、同种异体移植物-假体复合材料、同种异体重建、聚对苯二甲酸乙二醇酯(PET)管、假体本身和某些用于植入物涂层的金属,用于软组织重建。
虽然组织工程构建体和生物及细胞方法的进步显示出增强骨整合和与软组织和植入物相互作用的潜力,但实际的临床结果经常达不到预期。软组织整合的成功对于实现功能结果、最小化并发症以及确保骨科植入物的长期稳定性至关重要。