双动防脱位定制半骨盆假体10例临床应用早期疗效报告  

Design concept and initial clinical application of a double-motion hemipelvic prosthesis for pelvic tumor resection and reconstruction

作　　者：汪淼 许常利 汪秉轩 刘畅 李博 綦珂 刘天择 李诚 王志伟 WANG Miao;XU Chang-li;WANG Bin-xuan;LIU Chang;LI Bo;QI Ke;LIU Tian-ze;LI Cheng;WANG Zhi-wei(Department of Orthopaedics,Changhai Hospital,Naval Medical University,Shanghai,200433,China)

机构地区：[1]海军军医大学长海医院关节骨病外科,上海200433 [2]海军军医大学东方肝胆外科医院医学影像科,上海200433

出　　处：《中国骨与关节杂志》2022年第1期36-43,共8页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金(81671199);海军军医大学附属长海医院234学科攀峰项目(2019YXK055)。

摘　　要：目的评价利用双动防脱位定制半骨盆假体在进行骨盆肿瘤切除重建时的安全性及早期临床疗效。方法回顾性分析2017年至2020年,就诊于海军军医大学附属长海医院关节骨病外科的10例骨盆肿瘤患者的病例资料,其中男6例,女4例,平均年龄为45.2岁。均为原发性肿瘤,其中软骨肉瘤4例,骨肉瘤2例,纤维肉瘤1例,尤文肉瘤2例,骨巨细胞瘤1例。2例单纯侵犯骨盆Ⅱ区,1例侵犯Ⅰ、Ⅱ区,3例侵犯Ⅱ、Ⅲ区,4例同时侵犯Ⅰ、Ⅱ、Ⅲ区。Enneking原发恶性肿瘤分期:ⅡA期2例,ⅡB期8例。所有患者均使用双动防脱位定制半骨盆假体进行骨盆肿瘤的切除重建术。结果10例均得到随访,随访4~38个月,平均18.5个月。至末次随访,10例中8例(80.0%)仍存活,2例肿瘤局部复发,复发率为20.0%。围术期并发症总发生率为20.0%,包括1例深部感染,1例人工关节脱位。除去1例复发截肢的患者,其余7例在末次随访时国际骨肿瘤协会(Musculoskeletal Tumor Society,MSTS 93)的平均得分是64.4%(19.3/30分)。结论利用双动防脱位定制半骨盆假体在进行骨盆肿瘤的切除重建是一种安全有效的方法,患肢功能满意,术后并发症低,双动假体可以有效地防止术后假体脱位。Objective To evaluate the safety and early clinical efficacy of a double-motion hemipelvic prosthesis for pelvic tumor resection and reconstruction.Methods A retrospective analysis 2017-2020 was performed on the case data of 10 patients with pelvic tumors,including 6 males and 4 females with an average age of45.2 years (range:24-57 years).All the patients had primary tumors,spanning 4 cases of chondrosarcoma,2 cases of osteosarcoma,1 case of fibrosarcoma,2 cases of Ewing‘s sarcoma,and 1 case of giant cell tumor of bone.Initial tumor locations:2 cases of region Ⅱ,1 case of region Ⅰ + Ⅱ,3 cases of region Ⅱ + Ⅲ and 4 cases of regionⅠ + Ⅱ + Ⅲ.Enneking staging:2 case of stage Ⅱ,8 cases of stag ⅡB.All patients underwent pelvic tumor resection and reconstruction with a double-motion hemipelvic prosthesis.Results All the 10 patients were followed up for4-38 months,with an average of 18.5 months.At the last follow-up:8 (80.0%) of the 10 patients were still alive;2 patients had local tumor recurrence,with a recurrence rate of 20.0%.The total incidence of perioperative complications was 20.0%,including 1 case of deep infection and 1 case of dislocation of the artificial joint.Except for one recurrent patient with amputation,the average score of Musculoskeletal Tumor Society (MSTS 93) was 64.4% in the remaining 7 patients (19.3 / 30).Conclusions It is a safe and effective method to reconstruct the pelvis by a double-motion hemipelvic prosthesis.The function of the affected limb is satisfactory and the postoperative complications are less.It will effectively prevent the postoperative prosthesis dislocation.

关 键 词：骨盆 肿瘤 假体设计 

分 类 号：R738.1[医药卫生—肿瘤]