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Modified Harrington's procedure for periacetabular metastases in 89 cases: a reliable method for cancer patients with good functional outcome, especially with long expected survival.

改良哈灵顿手术治疗髋臼周围转移89例: 一种功能预后良好,特别是预期生存期长的癌症患者的可靠方法。

  • 影响因子:3.18
  • DOI:10.1080/17453674.2020.1732016
  • 作者列表:"Kask G","Nieminen J","van Iterson V","Naboistsikov M","Pakarinen TK","Laitinen MK
  • 发表时间:2020-06-01
Abstract

:Background and purpose - The pelvis is the 3rd most common site of skeletal metastases. In some cases, periacetabular lesions require palliative surgical management. We investigated functional outcome, complications, and implant and patient survival after a modified Harrington's procedure.Patients and methods - This retrospective cohort study included 89 cases of surgically treated periacetabular metastases. All patients were treated with the modified Harrington's procedure including a restoration ring. Lesions were classified according to Harrington. Functional outcome was assessed by Harris Hip Score (HHS) and Oxford Hip Score (OHS). Postoperative complications, and implant and patient survival are reported.Results - The overall postoperative functional outcome was good to fair (OHS 37 and HHS 76). Sex, age, survival > 6 and 12 months, and diagnosis of the primary tumor affected functional outcome. Overall implant survival was 96% (95% Cl 88-100) at 1 year, 2 years, and 5 years; only 1 acetabular implant required revision. Median patient survival was 8 months (0-125). 10/89 patients had postoperative complications: 6 major complications, leading to revision surgery, and 4 minor complications.Interpretation - Our modified Harrington's procedure with a restoration ring to achieve stable fixation, constrained acetabular cup to prevent dislocation, and antegrade iliac screws to prevent cranial protrusion is a reliable reconstruction for periacetabular metastases and results in a good functional outcome in patients with prolonged survival. A standardized procedure and low complication rate encourage the use of this method for all Harrington class defects.

摘要

背景和目的: 骨盆是第3最常见的骨转移部位。在某些情况下,髋臼周围病变需要姑息性手术治疗。我们调查了改良Harrington手术后的功能结果、并发症、植入物和患者存活率。患者和方法-这项回顾性队列研究包括89例手术治疗的髋臼周围转移。所有患者均采用包括修复环的改良Harrington术治疗。根据Harrington对病变进行分类。通过Harris髋关节评分 (HHS) 和牛津髋关节评分 (OHS) 评估功能结果。报告了术后并发症、种植体和患者存活率。结果-术后总体功能结果良好至公平 (OHS 37和HHS 76)。性别、年龄、存活> 6个月和12个月以及原发肿瘤的诊断影响功能结局。1年、2年和5年的总植入物存活率为96% (95% Cl 88-100); 仅1个髋臼植入物需要翻修。中位患者生存期为8个月 (0-125)。10/89例患者术后出现并发症: 6大并发症,导致翻修手术,4小并发症解读-我们改良哈灵顿术式配合修复环达到稳定固定,约束髋臼杯防止脱位,顺行髂骨螺钉防止颅骨突出是髋臼周围转移灶的可靠重建,在延长生存期的患者中产生良好的功能结果。标准化程序和低并发症发生率鼓励将该方法用于所有Harrington类缺陷。

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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