自体股骨头联合常规假体重建髋臼肿瘤切除后髋臼缺损的临床观察

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Abstract Objective To explore the feasibility of the treatment of acetabular defect with autologous femoral head combined with conventional prosthesis after excision of acetabular tumor，and to study the oncologic and functional prognosis of this operation by follow-up(≥2 years).Methods Five patients admitted to our hospital from April 2010 to October 2017 who underwent the treatment of acetabular defect with autologous femoral head combined with conventional prosthesis after excision of acetabular tumor.Inpreoperative preparation，all patients underwent radiographic and pathological examination to determine the nature，type，and extent of tumor involvement in the acetabulum.Then，the simulated resection of the tumor was carried out with the help of computer，and the personalized surgical scheme was designed.Postoperatively，all patients were restricted to weight-bearing.Walking was assisted by a walking aid 1 month after the operation，and walking independently 6 months after the operation.Postoperative follow-up was conducted to review the CT，MRI and X-ray of the pelvis，and the CT of the lungs，so as to evaluate the oncologic prognosis.Musculoskeletal oncology society score(MSTS)was used to evaluate functional prognosis. Results All the 5 cases received the operation successfully，achieved R0 resection of the tumor during the operation，and reconstruction of acetabulum with autologous bone grafting combined with Porous tantalum cup and conventional hip prosthesis.All patients were followed up for more than 2 years(range，24~120 months).Functional score was evaluated by MSTS at the last follow-up，and the functional score of 5 patients at the last follow-up was 26~30 points，with an average of (28.2±1.6)points.The imaging data during the follow-up in all patients indicated that the prosthesis was fixed in all patients，no acetabular prosthesis was displaced or loosened，and no joint dislocation was observed.There were no complications such as nonunion of bone graft，deep infection and poor healing of operative mouth in all patients.Conclusion This procedure maximizes the recovery of the normal rotation center of the acetabulum.Combined with the use of conventional porous tantalum metal cups andbconventional hip prosthesis，it achieves the early and long-term stability of the prosthesis from the perspective of anatomy and biology.The results of follow-up indicated that the operation is safe and effective，and achieved good recovery of hip joint function，realized long-term survival of artificial joint prosthesis after the operation of acetabular peripheral tumor，and improved the quality of life of patients.

Key words： periacetabular tumor acetabular defect autologous femoral head bone grafting

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[1]	. [J]. sygkzz, 2021, 27(6): 550-553.