Annals of palliative medicine · 2020
A modified surgical technique to simplify the procedure of femoral stem implantation for an appropriate anteversion angle during endoprosthetic reconstruction.
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Shi Lijun, Han Jun, Shi Lili, Sun Wei, Gao Fuqiang
Аннотация
BACKGROUND: In patients with bone tumors of the proximal femur, endoprosthetic reconstruction can provide stable and durable biological reconstruction. However, it is difficult and time-consuming to accurately place the femoral component for an appropriate anteversion angle after large tumor resection. We propose a modified surgical technique for simplifying the implantation process and promoting the stability of the artificial joint.
METHODS: We retrospectively analyzed the clinical data of 28 patients undergoing endoprosthetic reconstruction at our center between 2009 and 2016. We used a traditional method (group A, n=11) and a modified surgical technique (group B, n=17) to determine the femoral anteversion angle during implantation of the femoral component. The modified surgical technique allowed more convenient and accurate implantation of the femoral components by externally rotating the shin at an angle of 15°. Surgical time and blood loss were designated as the primary outcomes, hospital stays, postoperative complications and functional recovery [Harris Hip Score (HHS); Musculoskeletal Tumor Society Score (MSTS)] were recorded as the secondary outcomes. The outcomes of the two groups were compared to verify the safety and efficacy of the modified surgical technique.
RESULTS: The mean operative time was shorter in group B (109±10 minutes) than group A (131±6 minutes) (P<0.05). Although the average estimated intraoperative blood loss was less in group B (814±35 mL) than that in group A (839±30 mL), there was no significant difference between the two groups (P=0.06). There was no significant difference between the two groups in hospital stays, postoperative complications, HHS or MSTS.
CONCLUSIONS: This modified surgical technique can simplify the process of femoral component implantation and significantly shorten operative time without increasing postoperative complications.
METHODS: We retrospectively analyzed the clinical data of 28 patients undergoing endoprosthetic reconstruction at our center between 2009 and 2016. We used a traditional method (group A, n=11) and a modified surgical technique (group B, n=17) to determine the femoral anteversion angle during implantation of the femoral component. The modified surgical technique allowed more convenient and accurate implantation of the femoral components by externally rotating the shin at an angle of 15°. Surgical time and blood loss were designated as the primary outcomes, hospital stays, postoperative complications and functional recovery [Harris Hip Score (HHS); Musculoskeletal Tumor Society Score (MSTS)] were recorded as the secondary outcomes. The outcomes of the two groups were compared to verify the safety and efficacy of the modified surgical technique.
RESULTS: The mean operative time was shorter in group B (109±10 minutes) than group A (131±6 minutes) (P<0.05). Although the average estimated intraoperative blood loss was less in group B (814±35 mL) than that in group A (839±30 mL), there was no significant difference between the two groups (P=0.06). There was no significant difference between the two groups in hospital stays, postoperative complications, HHS or MSTS.
CONCLUSIONS: This modified surgical technique can simplify the process of femoral component implantation and significantly shorten operative time without increasing postoperative complications.