人工关节置换、鞍式假体重建及异体骨移植在髋周围骨肿瘤治疗中的应用

背景：髋周围骨肿瘤是全身骨肿瘤好发部位，由于累及负重区，肿瘤切除难度大，对手术技术要求较高，同时往往需要重建骨盆及髋关节功能。 目的：比较髋周围骨肿瘤切除后3种不同修复重建方法的效果。 方法：收集2007年1月至2012年12月于武汉大学中山医院进行手术治疗的髋周围骨肿瘤患者20例，其中良性7例，交界性和恶性13例。均以手术切除治疗。8例采用异体骨移植，8例采用人工关节置换，4例采用鞍式假体重建。 结果与结论：20例均获得随访，随访时间5-60个月，平均40个月。根据Enneking评分标准，优8例﹑良5例﹑中4例﹑差3例，评估优良率65%。证实髋周肿瘤采用手术切除治疗，切除后采用异体骨移植、人工关节置换或鞍式假体重建能提高患者生存率，改善患者生活质量，是髋周肿瘤有效治疗方法。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：

Arthroplasty,saddle prosthesis and allograft in the treatment of bone tumors around the hip

BACKGROUND:The region around the hip is a bone tumor predilection site. It is difficult to conduct tumor resection due to the involvement of weight loading area. Tumor resection requires high surgical technique. The pelvis and hip are often needed to be rebuilt. OBJECTIVE: To compare the effects of three reconstruction methods after tumor resection around the hip. METHODS: From January 2007 to December 2012, 20 patients with bone tumors around the hip were treated by surgery in the Zhongshan Hospital, Wuhan University, including 7 benign tumors, 13 borderline and malignant tumors. Eight patients received allograft. Eight patients received arthroplasty. Four patients received saddle prosthesis. RESULTS AND CONCLUSION:A total of 20 patients were followed up for 5 to 60 months (averagely 40 months). According to Enneking evaluation criterion, the operative outcome was evaluated as excellent in 8 cases, good in 5 cases, average in 4 cases, and poor in 3 cases. Excellent and good rate was 65%. Results suggested that after excision of bone tumors, allograft, arthroplasty or saddle prosthesis can significantly elevate patient’s survival rate, improve patient’s living quality and is an effective therapy for treating tumors around the hip.