股骨近端恶性肿瘤伴关节侵犯时的关节外髋关节切除术与骨盆连续性的保持。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-07-01 Epub Date: 2024-05-08 DOI:10.1177/11207000241249135
Guillaume-Anthony Odri, Cédric Yatim, Diane Ji Yun Yoon, Pierre-Alban Bouche, Mathieu Severyns, Pascal Bizot
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引用次数: 0

摘要

导言:盆骨或股骨近端恶性肿瘤侵犯髋关节时,可能需要进行髋关节外切除术。当肿瘤位于股骨近端时,可以通过髋臼周围截骨术对髋臼进行整体切除,但这会造成骨盆环的不连续性,导致重建困难和功能减退。最近介绍的几种技术试图通过保留后柱或双柱来尽可能保留骨盆骨,以方便重建和改善功能。然而,这些技术仍然需要复杂的重建,并可能需要进行骨盆内剥离:我们在此介绍一种针对侵犯关节的股骨近端肿瘤的关节外髋关节切除技术,该技术通过保留髋臼的两根支柱和四边形骨板来保持骨盆的连续性,无需骨盆内剥离,适用于髋臼内侧壁足够厚的患者。我们的初步评估包括干骨研究和成像分析。该技术首先在一个尸体骨盆(包括两个髋关节)上进行了测试,随后在一名因继发于帕吉特氏病的骨肉瘤而导致股骨颈病理性骨折的患者身上进行了测试:进一步的临床应用对于评估该实验技术的整体有效性、安全性和对患者功能的影响至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Extra-articular hip resection with maintenance of pelvic continuity in malignant tumours of the proximal femur with articular invasion.

Introduction: Extra-articular hip resection may be necessary in cases of malignant tumour of the pelvic bone or of the proximal femur invading the hip joint. When the tumour is in the proximal femur, it is possible to resect the acetabulum en bloc by performing a periacetabular osteotomy, but this creates a discontinuity in the pelvic ring with difficult reconstruction and diminished function. Several techniques described recently seek to be as sparing as possible on the pelvic bone by preserving the posterior column or both columns in order to facilitate reconstruction and improve function. However, these still require complex reconstructions and can necessitate intra-pelvic dissection.

Technique: We describe here an extra-articular hip resection technique for tumours of the proximal femur invading the joint, with maintenance of pelvic continuity by preserving both columns and the quadrilateral plate of the acetabulum, without intra-pelvic dissection, that can be performed on patients in whom the medial wall of the acetabulum is thick enough. Our preliminary assessments have included studies on dry bone and imaging analyses. The technique was first tested on a single cadaver pelvis (encompassing 2 hips) and subsequently performed on a patient with a pathological fracture of the femoral neck due to osteosarcoma secondary to Paget's disease.

Conclusions: Further clinical applications are essential to evaluate the overall effectiveness, safety and impact on patient functionality of this experimental technique.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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