肿瘤和非肿瘤适应症股骨近端大假体的并发症风险和再手术率相似。

IF 2 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2025-02-01 Epub Date: 2025-01-09 DOI:10.1007/s00264-025-06408-4

Guillaume Tran, Denis Waast, Christophe Nich, Morgane Pere, Juliane Berchoud, Francois Gouin, Vincent Crenn

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引用次数: 0

摘要

目的：近端股骨巨型假体（pfmp）用于治疗非肿瘤指征（NOI）和肿瘤指征（OI）的大骨缺损。然而，对于这两组之间的再手术风险和功能结果的比较了解甚少。本研究旨在评估NOI和OI之间pfmp的再手术累积发生率和功能结果。方法：这项回顾性、单中心队列研究包括2005年至2020年期间109个植入物(NOI, n = 42；OI, n = 67)。竞争风险分析用于估计和比较再手术和并发症的累积发生率，并将死亡作为竞争事件。回顾性评估肌肉骨骼肿瘤学会评分（MSTS）以比较功能预后。结果：估计10年的累计再手术发生率无统计学差异：NOI为33.5%，OI为32.7% （HR = 0.90, 95% CI (0.42-0.95), p = 0.791）。估计10年并发症的累积发生率无统计学差异（HR = 1.50, 95%CI (0.80-2.80), p = 0.204）。OI组10年MSTS评分（78.2%±19.5）明显高于NOI组（48.3%±10.9）（p = 0.012）。结论：pfmp治疗NOI的再手术风险与OI相当，但长期功能预后较低。

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Similar risks of complications and reoperation rates in proximal femur megaprostheses for oncological and non-oncological indications.

Purpose: Proximal femur megaprostheses (PFMPs) are used to manage large bone defects in both non-oncological indications (NOI) and oncological indications (OI). However, little is known about the comparative risks of reoperation and functional outcomes between these groups. This study aimed to evaluate the cumulative incidences of reoperation and functional results of PFMPs between NOI and OI.

Methods: This retrospective, monocentric cohort study included 109 implants between 2005 and 2020 (NOI, n = 42; OI, n = 67). Competing risk analysis was used to estimate and compare cumulative incidence of reoperation and complications, with death as a competing event. The Musculoskeletal Tumour Society Score (MSTS) was retrospectively assessed to compare functional outcomes.

Results: The estimated cumulative incidence of reoperation at ten years did not statistically differ: 33.5% for NOI vs. 32.7% for OI (HR = 0.90, 95% CI (0.42-0.95), p = 0.791). The estimated cumulative incidence of complications at ten years did not statistically differ (HR = 1.50, 95%CI (0.80-2.80), p = 0.204). The MSTS score at ten years was significantly higher in the OI group (78.2% ± 19.5) compared to the NOI group (48.3% ± 10.9) (p = 0.012).

Conclusion: PFMPs for NOI demonstrate a comparable risk of reoperation to OI, but with lower long-term functional outcomes.

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.