限制性内衬全髋关节假体在髋周肿瘤切除术后髋关节重建术中的应用

Application of total hip arthroplasties with constrained acetabular liners following peri-hip tumor resection

目的探讨限制性内衬全髋关节假体在髋周肿瘤切除术后的髋关节重建术中的应用。方法回顾性分析12例采用限制性内衬假体行全髋关节重建的髋周恶性肿瘤患者的临床资料。其中4例骨盆肿瘤,8例股骨近端肿瘤。对患者随访14~45个月,平均30.7个月,随访记录患者的生存情况,患肢肌肉骨骼肿瘤协会(The Musculoskeletal Tumor Society,MSTS)功能评分及并发症。结果患者肿瘤切除术后2年和3年生存率分别为91.7%和83.3%。所有患者均未发生假体脱位。2例发生并发症(分别为假体周围感染和下肢深静脉血栓形成)。末次随访的MSTS评分为12~28分,(20.67±3.35)分。所有患者均出现步态异常。结论在髋周肿瘤切除术后采用限制性内衬全髋关节置换术早期临床效果良好。

Objective To explore the application of total hip arthroplasties(THAs)with constrained acetabular liners(CALs)following peri-hip tumor resection.Methods The clinical data of 12 patients with peri-hip tumor who underwent THAs with CALs were retrospectively analyzed.There were 4 patients with pelvic tumors and 8 patients with femoral proximal tumors.Patients were followed up for 14 to 45 months,with a mean of 30.7 months.Patients’survival,the Musculoskeletal Tumor Society(MSTS)score and complications were recorded.Results The 2-and 3-year survival rates of all patients after tumor resection and reconstruction were 91.7%and 83.3%,respectively.No dislocation occurred during the follow-up.Two patients suffered from complications(periprosthetic infection in one case and deep venous thrombosis in the lower extremity in another).The MSTS score at the last follow-up was(20.67±3.35)(range:12 to 28).All patients developed slightly gait abnormalities.Conclusion A CAL appears to be a safe and appropriate option for hip reconstruction following peri-hip tumor resection.