转移性骨病患者的髋关节置换术效果。

IF 1.4 Q3 ORTHOPEDICS Orthopedic Reviews Pub Date : 2024-03-17 eCollection Date: 2024-01-01 DOI:10.52965/001c.94568
Sarah C Tepper, Linus Lee, Lucas B Kasson, Leyla R Herbst, Gayathri Vijayakumar, Matthew W Colman, Steven Gitelis, Alan T Blank
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引用次数: 0

摘要

背景/目的:髋关节是转移性骨病(MBD)的常见部位,通常需要通过手术干预来缓解疼痛和改善功能。髋关节转移性骨病通常采用半关节成形术治疗,如果存在髋臼病变,则采用全髋关节成形术治疗。随着转移性疾病治疗方法的不断发展,患者在确诊后可能会活得更长,因此有必要进一步评估与髋关节置换术治疗 MBD 相关的并发症和功能结果:这是一项回顾性研究,研究对象是 2007 年至 2021 年期间在一家医疗机构接受髋关节置换术治疗 MBD 的患者。结果包括再手术率、并发症和总生存率:结果:共纳入 91 名患者的 93 个病例。52例(55.9%)患者进行了全髋关节置换术(THA),15例(16.1%)患者进行了半髋关节置换术,26例(28%)患者进行了复杂关节置换术,包括股骨近端置换术或带有复杂髋臼重建的THA。有5名患者接受了11次再手术,6人脱位。中位生存期为10.4个月,一年总生存期为53.3%。术后能独立行走的患者比例明显增加(35.2% vs 17.6%; p=0.02),只能坐轮椅的患者明显减少(18.7% vs 3.3%; p=0.045):结论:髋关节置换术治疗 MBD 的并发症发生率和再次手术率相对较低,众所周知,这一人群术后发病率和死亡率较高。髋关节置换术为大多数 MBD 患者提供了持久的重建,超过了他们的寿命,使他们能够恢复到可接受的功能水平。
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Hip Arthroplasty Outcomes in Patients with Metastatic Bone Disease.

Background/objective: The hip is a common location for metastatic bone disease (MBD) and surgical intervention is often indicated to relieve pain and improve function. MBD of the hip is usually treated with hemiarthroplasty or with total hip arthroplasty if there are acetabular lesions. As treatment for metastatic disease evolves and patients may expect to live longer after diagnosis, further evaluation of the complications and functional outcomes associated with hip arthroplasty for MBD are necessary.

Methods: This was a retrospective review of patients who underwent hip arthroplasty for MBD at a single institution between 2007 and 2021. Outcomes included rates of reoperation, complications, and overall survival.

Results: Ninety-three cases in 91 patients were included. Total hip arthroplasty (THA) was performed in 52 cases (55.9%), hemiarthroplasty in 15 (16.1%), and complex arthroplasty, including proximal femur replacement or THA with complex acetabular reconstruction, was performed in 26 (28%). There were 11 reoperations in five patients and six dislocations. Median survival was 10.4 months and one-year overall survival was 53.3%. There was a significant increase in the proportion of patients who were able to ambulate independently (35.2% vs 17.6%; p=0.02) and a significant decrease in patients confined to a wheelchair (18.7% vs 3.3%; p=0.045) after surgery.

Conclusions: Hip arthroplasty for MBD leads to relatively low rates of complications and reoperations in this population known to have high postoperative morbidity and mortality. Hip arthroplasty provides the majority of MBD patients with a durable reconstruction that exceeds their lifespan and enables them to return to an acceptable level of function.

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来源期刊
Orthopedic Reviews
Orthopedic Reviews ORTHOPEDICS-
CiteScore
2.70
自引率
4.80%
发文量
122
审稿时长
10 weeks
期刊介绍: Orthopedic Reviews is an Open Access, online-only, peer-reviewed journal that considers articles concerned with any aspect of orthopedics, as well as diagnosis and treatment, trauma, surgical procedures, arthroscopy, sports medicine, rehabilitation, pediatric and geriatric orthopedics. All bone-related molecular and cell biology, genetics, pathophysiology and epidemiology papers are also welcome. The journal publishes original articles, brief reports, reviews and case reports of general interest.
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