Joint preservation in revision arthroplasty and intercalary tumour implants using custom stem solutions.

IF 2.2 3区医学 Q2 ORTHOPEDICS

BMC Musculoskeletal Disorders Pub Date : 2024-11-05 DOI:10.1186/s12891-024-07997-8

Yannik Hanusrichter, Carsten Gebert, Sven Frieler, Ole Somberg, Marcel Dudda, Arne Streitbuerger, Jendrik Hardes, Martin Wessling

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引用次数: 0

Abstract

Background: Off-the-shelf stems offer a wide variety of fixation methods for revision arthroplasty and intercalary tumour implants. However, in extensive defects or needed resection with minimal bone stock left, solid fixation is often not feasible with these implants. Custom-made stem solutions (CSS) offer a viable alternative in these cases to achieve joint preservation.

Methods: Between 2017 and 2024 14 patients (15 implants) were treated in a single-centre study. CSS were indicated if the remaining bone stock was deemed insufficient for normal stem fixation due to tumour resection or previous operations. Postoperative analysis was conducted to evaluate the functional outcome as well as revision rates.

Results: Implantation was possible in all cases, during the follow-up of 30 (SD 18; 6-66) months revision was needed in five cases; with one aseptic loosening, one screw loosening and three PJI cases. Mean MSTS score was 24 (SD 5; 17-30).

Conclusion: Custom-made stem solutions show promising results in extreme cases. Especially as a preservation of the joint is possible, this treatment algorithm should be considered on a case-by-case basis.

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在翻修关节置换术和椎间肿瘤植入术中使用定制的骨干解决方案保护关节。

背景：现成的柄为翻修关节置换术和肿瘤闰间植入物提供了多种固定方法。然而，在大面积缺损或需要切除且骨量极少的情况下，使用这些植入物往往无法实现牢固固定。定制骨干解决方案（CSS）为这些病例提供了可行的替代方案，以实现关节保留：在 2017 年至 2024 年期间，一项单中心研究对 14 名患者（15 个植入物）进行了治疗。如果由于肿瘤切除或之前的手术导致剩余骨量不足以进行正常的骨干固定，则需要使用 CSS。术后分析评估了功能结果和翻修率：所有病例均可植入，在30个月（SD 18；6-66）的随访期间，5例病例需要进行翻修；其中1例为无菌性松动，1例为螺钉松动，3例为PJI。平均MSTS评分为24（SD 5；17-30）：结论：定制的骨干解决方案在极端病例中显示出良好的效果。结论：定制骨干解决方案在极端病例中显示出良好的效果，尤其是在可能保留关节的情况下，应根据具体情况考虑这种治疗算法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Musculoskeletal Disorders 医学-风湿病学

CiteScore

3.80

自引率

8.70%

发文量

1017

审稿时长

3-6 weeks

期刊介绍： BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.