较大的干与骨径比率预测了较低的固内脏假体失败
Yazan Kadkoy1, Joseph A Ippolito1, Gregory Schneider1
1Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Journal of surgical oncology
|January 15, 2024
概括
使用更大的茎直径在水泥内置假体重建减少植入物失败. 茎与骨径比低于40%显著增加了部和膝关节置换中无菌松动和机械故障的风险.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 在瘤学瘤学.
背景情况:
- 患有内脏假体重建的患者寿命更长,对植入物的依赖性越来越大.
- 无菌松动和机械故障是导致内膜假体故障的主要原因.
- 瘤切除,骨质损失和放射治疗都会增加并发症的风险.
研究的目的:
- 为了确定5年随访后内置假肢失败的整体率.
- 调查切除长度是否影响植入物失败率.
- 评估植入物大小和干与骨的比例是否会影响内脏假体的失败.
主要方法:
- 对150名接受固部或膝盖内置假肢重建 (1999-2022) 的患者进行了回顾性分析.
- 对55名患者进行了X射线评估,对切除长度,骨径和茎径进行了长达5年的随访.
- 切除百分比和干与骨径比率的计算,以分析故障关系.
主要成果:
- 植入物失败与较小的平均茎到骨径有关 (36%对44%).
- 干到骨径比率<40%是一个关键值,90%的故障发生在这个比率以下.
- 干与骨的比率<40%显著增加了故障风险 (OR 0.68,p<0.001).
- 切割长度没有影响失败率.
结论:
- 较大的茎直径有利于水泥部和膝盖内置假体.
- 骨干直径比低于40%的骨干直径比大大增加了植入物失败的可能性.
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