Introduction: Over the past few decades, tumor arthroplasty has evolved into an established therapeutic approach for addressing bone defects following tumor resection in the extremities. As the diagnosis has a significant impact on patients’ lives, it is important to give clear expectations for functional recovery. Therefore, we investigated both the functional outcomes and the quality of life (QoL) after tumor arthroplasty for malignant hip tumors. Methods: This retrospective study included patients who had undergone resections of malignant hip tumors with consecutive modular hip arthroplasty between 2010 and 2018. Demographics, tumor entity, and complications stemming from both tumors and treatments were evaluated through the analysis of medical records and perioperative records. The assessment of functional outcomes was conducted with the following patient-reported outcome measures (PROMs): the Harris Hip Score (HHS), Musculoskeletal Tumor Society Score (MSTS), and the Short Form Survey 36 (SF-36). Furthermore, we performed subgroup analysis in two groups: one divided into survivors and non-survivors, as well as younger individuals (<57 years) and older individuals (>57 years). Results: A total of 30 patients were included in the study. At the time of follow-up, 19 patients were deceased. The average duration of follow-up was 3.2 (±2.51) years. The average age at the time of surgery was 60.3 (±15.20) years. Notably, there were no cases of amputation reported (0%). Five cases of implant failure were identified (16.67%). Among these, one was attributed to infection (3.3%), while four resulted from aseptic loosening (13.3%). In terms of functional outcomes, MSTS indicated good results (18 ± 7; range: 7–28; 60%), and the HHS demonstrated moderate outcomes (75.3%). Younger survivors (<57 years) exhibited notably superior results in terms of both the MSTS and physical functioning in the SF-36 (p= 0.03). Conclusion: In summary, this study shows declining tumor arthroplasty-related complications and satisfying functional outcomes as well as QoL. Noteworthy aspects include the relatively low rates of amputation and local tumor recurrences, which significantly favor the selection of appropriate therapeutic options. Moreover, the findings underscore the substantial impact of patients’ age on overall functionality and engagement in daily activities.
引言：过去几十年间，肿瘤关节成形术已发展成为治疗四肢肿瘤切除术后骨缺损的成熟疗法。由于该诊断对患者生活影响重大，明确功能恢复预期至关重要。为此，我们研究了恶性髋部肿瘤患者接受肿瘤关节成形术后的功能结局与生活质量。 方法：本回顾性研究纳入2010年至2018年间接受恶性髋部肿瘤切除并序贯进行模块化髋关节置换术的患者。通过分析病历与围手术期记录，评估人口统计学特征、肿瘤实体及肿瘤与治疗相关并发症。功能结局评估采用以下患者报告结局指标：哈里斯髋关节评分、肌肉骨骼肿瘤协会评分及简明健康调查量表36项。此外，我们进行了亚组分析：按生存状态分为存活组与死亡组，按年龄分为年轻组（<57岁）与年长组（>57岁）。 结果：研究共纳入30例患者。随访时19例患者已死亡。平均随访时间为3.2（±2.51）年。手术时平均年龄为60.3（±15.20）岁。值得注意的是，未报告截肢病例（0%）。发现5例假体失效（16.67%），其中1例归因于感染（3.3%），4例由无菌性松动引起（13.3%）。功能结局方面，肌肉骨骼肿瘤协会评分显示良好结果（18±7分；范围：7-28分；60%），哈里斯髋关节评分显示中等结果（75.3分）。年轻存活者（<57岁）在肌肉骨骼肿瘤协会评分及简明健康调查量表36项躯体功能维度均表现出显著更优结果（p=0.03）。 结论：本研究显示肿瘤关节成形术相关并发症呈下降趋势，功能结局与生活质量令人满意。值得注意的方面包括相对较低的截肢率与局部肿瘤复发率，这为选择适宜治疗方案提供了重要依据。此外，研究结果强调了患者年龄对整体功能状态与日常活动参与的显著影响。
Outcome of Endoprosthetic Hip Reconstruction Following Resection of Malignant Bone Tumors
肿瘤(癌症)患者之家