定制人工股骨头治疗股骨上段转移性肿瘤

目的探讨股骨上段转移性肿瘤定制人工股骨头置换治疗的近期疗效。方法对14例股骨上段转移性肿瘤患者行瘤段骨切除和定制人工股骨头置换手术治疗。肾功能正常患者术后2周开始二膦酸盐类药物口服,并对患者的临床表现、局部影像学、疼痛情况及患侧肢体术后功能进行观察评定。结果术后患髋疼痛基本缓解,关节活动功能恢复满意,可满足日常行走和负重需要。14例均获随访,时间6～38个月。随访期内无假体松动、脱位及假体周围骨折等发生,手术局部肿瘤无复发。术后3个月时髋关节Harris评分:优4例,良9例,可1例。结论对股骨近段转移性肿瘤采用定制人工股骨头重建,可有效缓解疼痛,保留肢体功能,提高生存质量。

Customized prosthesis replacement for metastatic bone tumors in proximal femur

Objective To evaluate the effect of proximal femoral arthroplasty for metastatic bone tumors.Methods 14 patients with metastatic bone tumors in proximal femur were treated with En bloc resection and proximal femoral replacement.The administration of bisphosphonates to postoperative patients was begun at the third week after operation.The clinical outcomes were evaluated by orthopedic and radiological examination.Results In all patients,the pain was almost relieved;hip function and daily life were restored after operation.The hip function was evaluated with Harris′s score(excellent 4 cases,good 9 cases and fair 1 case).The follow-up period ranged from 6 to 38 months.Aseptic loosening,dislocation,fractures around implants and tumor recurrence were not observed.Conclusions Proximal femoral replacement can results in excellent local disease control,reliable pain relief and restoration of hip function for the patients of proximal femoral metastatic tumors.