定制羟基磷灰石包覆的骨干环与骨外板在翻修中提供了良好的长期效果,包括短节段,假体内肿瘤重建

IF 1.5 Q4 ONCOLOGY
Cancer reports Pub Date : 2025-06-25 DOI:10.1002/cnr2.70254
Patrick Qi Wang, Kwok Chuen Wong
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引用次数: 0

摘要

骨肿瘤切除术后假体内重建的无菌性松动是一个主要问题,特别是在翻修/多次翻修的情况下。目的是展示修复肢体保留手术的长期结果,使用定制的羟基磷灰石涂层干环,在骨-种植体连接处放置一个专门设计的外板,以防止无菌性松动。方法选取2004年至2016年间15例采用该种植体规格进行翻修手术的首次四肢骨肿瘤切除重建患者。分别有6例和9例患者进行了多次手术和短节段茎固定(< 100 mm)。结果感兴趣的是无菌性松动率和骨整合的x线证据以及临床和功能结果。结果在平均12年的随访(6.5 - 18年)中,没有患者有影像学或临床无菌性松动的证据。股骨远端定位(p = 0.044)、假体内重建作为指标(p = 0.026)、机械故障作为翻修的原因(p = 0.0047)和额外的骨外钢板固定(p = 0.041)与较高的骨长入评分相关。除了两名只有轻微疼痛的患者外,其他患者都没有疼痛。关节活动范围(p < 0.0001)和四肢长度差异(p = 0.021)显著改善。肌肉骨骼肿瘤学会平均评分为26.1分(优)。结论:该研究表明,该定制的植入物规格在预防长期无菌性松动方面效果优异,尤其适用于翻修/多次翻修和短节段固定。然而,需要进一步的大规模和多中心研究来验证更广泛人群的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Custom Hydroxyapatite-Coated Stem Collar With Extracortical Plate Provides Excellent Long-Term Results Against Aseptic Loosening in Revision, Including Short-Segment, Endoprosthetic Tumour Reconstruction

Custom Hydroxyapatite-Coated Stem Collar With Extracortical Plate Provides Excellent Long-Term Results Against Aseptic Loosening in Revision, Including Short-Segment, Endoprosthetic Tumour Reconstruction

Background

Aseptic loosening from endoprosthetic reconstructions following bone tumour resection is a major issue, especially in the revision/multiple revisions settings. The objective was to present long-term outcomes of revision limb salvage surgery using a custom hydroxyapatite-coated stem collar with an extracortical plate at the bone-implant junction specifically designed to prevent aseptic loosening.

Methods

Fifteen (15) patients with an initial extremity bone tumour resection and reconstruction who underwent revision surgery utilizing this implant specification between 2004 and 2016 were included. Multiple prior surgeries and short-segment stem fixation (< 100 mm) were observed in six and nine patients, respectively. Outcomes of interest were rates of aseptic loosening and radiographic evidence of osseointegration along with clinical and functional outcomes.

Results

At mean 12-year follow-up (range 6.5 to 18), no patient had evidence of radiographic or clinical aseptic loosening. The distal femur location (p = 0.044), endoprosthetic reconstruction as index procedure (p = 0.026), mechanical failure as reason for revision (p = 0.0047) and additional fixation to the extracortical plate (p = 0.041) were associated with higher bone ingrowth scores. All but two patients, who had mild pain only, were pain-free. Joint range of motion (p < 0.0001) and limb-length discrepancy (p = 0.021) significantly improved. The mean Musculoskeletal Tumor Society score was 26.1 (excellent).

Conclusions

This study demonstrated excellent results in preventing long-term aseptic loosening with this custom implant specification, which is useful particularly for revisions/multiple revisions and short-segment fixation. However, further larger scale and multicentric studies are needed to validate the data to the broader population.

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来源期刊
Cancer reports
Cancer reports Medicine-Oncology
CiteScore
2.70
自引率
5.90%
发文量
160
审稿时长
17 weeks
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