LARS肿瘤管在肿瘤型人工髋关节置换术关节功能重建中的临床应用  

Clinical application of LARS tumor tube in joint function reconstruction of tumor type artificial hip replacement

作　　者：曾昊 何洪波[1] 章灿[1] 刘育鹏[1] 童小鹏 邱新铸 刘擎[1] ZENG Hao;HE Hongbo;ZHANG Can;LIU Yupeng;TONG Xiaopeng;QIU Xinzhu;LIU Qing(Department of Orthopaedics,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院骨科,长沙410008

出　　处：《中南大学学报（医学版）》2024年第4期578-587,共10页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2022JJ40802,2022JJ30928);长沙市自然科学基金(kq2202382);中国博士后科学基金(2022M713525)。

摘　　要：目的:股骨近端肿瘤切除常导致髋关节不稳定和功能缺失,临床上已有多种方法用于修复髋关节软组织功能,但仍存在不足。本研究旨在评价韧带高级加固系统(ligament advanced reinforcement system,LARS)肿瘤管对辅助肿瘤型人工髋关节置换术患者软组织功能重建的优势与不足。方法:2012年1月至2022年1月本研究共纳入湘雅骨肿瘤治疗中心的股骨近端肿瘤患者85例(男41例,女44例),年龄10~79(38.5±18.2)岁,其中良性侵袭性肿瘤13例,原发恶性骨肿瘤45例,骨转移瘤27例。收集患者的临床资料、影像学资料和术中照片,对患者进行随访和术后功能评价。分别采用肌肉骨骼肿瘤学会(Musculoskeletal Tumor Society,MSTS)评分系统和Harris髋关节评分系统评价患者的肢体功能和髋关节功能。结果:37例(43.5%)患者术前合并病理性骨折,病灶长度为(9.4±2.9)cm。非转移瘤患者术后复发7例,其中骨肉瘤6例,纤维肉瘤1例。9例骨肉瘤患者出现肺转移。5例因术后并发症再次手术,其中3例为深静脉血栓形成,1例为巨细胞肉芽肿,1例为假体周围感染。5例术后出现Trendelenburg步态。6例术后出现双下肢不等长。患者术后MSTS评分为26.7±1.4,Harris评分为89.6±5.3。结论:LARS肿瘤管可以有效辅助重建患者髋关节的软组织功能,并极大地减少了术后并发症的发生,是肿瘤型人工髋关节置换术中关节功能重建的有效技术改良。Objective:Proximal femur tumor resection often leads to hip joint instability and functional loss.Various methods have been clinically applied to repair hip joint soft tissue function,but deficiencies remain.This study aims to evaluate the advantages and disadvantages of the ligament advanced reinforcement system(LARS)tumor tube in assisting soft tissue function reconstruction in patients undergoing tumor type artificial hip replacement surgery.Methods:This study included 85 patients(41 males,44 females)with proximal femoral tumors treated at the Xiangya Bone Tumor Treatment Center from January 2012 to January 2022,aged 10 to 79(38.5±18.2)years.Among them,13 cases had benign aggressive tumors,45 had primary malignant bone tumors,and 27 had bone metastases.Clinical data,imaging data,and intraoperative photos were collected.Patients were followed up and postoperative functional evaluations were conducted using the Musculoskeletal Tumor Society(MSTS)scoring system and Harris hip joint scoring system to assess limb function and hip joint function.Results:Preoperative pathological fractures were present in 37 cases(43.5%),with a lesion length of(9.4±2.9)cm.Among non-metastatic tumor patients,7 experienced postoperative recurrence,including 6 cases of osteosarcoma and 1 case of fibrosarcoma.Pulmonary metastases occurred in 9 osteosarcoma patients.Five patients required reoperation due to postoperative complications,including 3 cases of deep vein thrombosis,1 case of giant cell granuloma,and 1 case of prosthesis infection.Postoperatively,5 patients exhibited Trendelenburg gait,and 6 had leg length discrepancies.The postoperative MSTS score was 26.7±1.4,and the Harris score was 89.6±5.3.Conclusion:The LARS tumor tube can effectively assist in reconstructing the soft tissue function of the hip joint and greatly reduce postoperative complications,making it an effective technical improvement in joint function reconstruction in tumor type artificial hip replacement surgery.

关 键 词：韧带高级加固系统肿瘤管 肿瘤型人工髋关节 软组织重建 关节功能 动力系统 

分 类 号：R738[医药卫生—肿瘤]