特制人工髋关节假体在髋部骨肿瘤的应用分析

目的探讨特制人工假体在髋部肿瘤保肢术中的应用价值。方法回顾性分析我院自1999年3月至2005年5月髋部原发肿瘤患者行特制人工假体置换术后疗效、并发症及处理资料。本组肿瘤病例中,髋臼11例,股骨近端15例;肿瘤类型:软骨肉瘤3例,骨肉瘤6例,滑膜肉瘤1例,骨巨细胞瘤12例,良性纤维组织瘤2例,动脉瘤样骨囊肿2例。假体类型:人工全髋关节假体17例,人工双极股骨头7例,马鞍式关节假体2例。结果随访时间为18个月～6年,平均4年3个月;10例恶性肿瘤局部复发率40%,保肢率60%,16例中间性及良性肿瘤复发率12.5%,保肢率87.5%,参照Enneking(MSTS)评定标准平均得分19分,优良率76.9%。结论特制人工髋关节假体具有良好的术后肢体功能,是髋部骨肿瘤较为满意的保肢治疗方法之一。

The application of custom-made artificial hip prosthesis in limb salvage treatment of patients with bone tumors in hip joint

Objective To evaluate the application of prosthetic replacement in limb salvage treatment of bone tumors involving hip joint.Methods Twenty-six patients with primary tumors involving hip joint were treated surgically in our hospital between March 1999 and May 2005.Their limb function complication and management were analyzed.There were 10 malignant tumors including 3 chondrosarcomas,6 osteosarcomas,1 synovial sarcoma,12 giant cell tumors,2 benign fibrous histiocytomas,2 aneurysmal bone cysts.The types of the prostheses were as follow:total hip replacement(17 cases),bipolar femoral prostheses(7 cases),saddle-like prostheses(2 cases).Results In the patients with malignant bone tumors local recurrence was 40% and final limb salvage rate was 60%.In the patients with benign bone tumors local recurrence was 12.5% and the final limb salvage rate was 87.5%.The total limb salvage rate was 76.9%.Conclusion Custom-made artificial hip prosthesis is satisfactory in the limb salvage surgery of patients with malignant or benign bone tumors in hip joint.