Background:The reconstruction of diaphyseal bone defects following tumor resection offers various biological and endoprosthetic treatment options. The present study analyzes the impact of the fixation method (cemented; uncemented; with locking screw; without locking screw) of the diaphyseal implant on clinical outcomes. Factors such as patient age and weight as well as tumor type and location are also considered.Methods:This study included 39 patients who underwent intercalary endoprosthetic reconstruction of the humerus (n = 4); femur (n = 29); and tibia (n = 6) between 1998 and 2020. Prosthetic complications, fixation methods and the MSTS score for functional outcome were statistically analyzed using SPSS and R.Results:The event-free probability in the competing risk model was 61% (95% CI 43–74%) after one year and 11% (95% CI 3–28%) after five years. The complication rate in the patient cohort was 54%. Cementless prosthesis fixation was associated with a statistically significant better functional outcome. Additionally, higher body weight and older patient age were associated with lower MSTS scores.Conclusions:Patients requiring rapid remobilization or adjuvant radiation therapy may benefit more from diaphyseal implants compared to biological reconstructions. However, the complication and revision rates of diaphyseal implants are elevated. The chosen fixation method shows a statistically significant influence on functional outcome.
背景：肿瘤切除术后骨干骨缺损的重建有多种生物学和假体治疗方案。本研究分析了骨干假体固定方式（骨水泥型；非骨水泥型；带锁定螺钉；不带锁定螺钉）对临床结果的影响。同时考虑了患者年龄、体重以及肿瘤类型和位置等因素。 方法：本研究纳入了1998年至2020年间接受肱骨（n=4）、股骨（n=29）和胫骨（n=6）节段性假体重建的39例患者。使用SPSS和R软件对假体并发症、固定方式以及用于功能评估的MSTS评分进行了统计分析。 结果：在竞争风险模型中，一年无事件概率为61%（95% CI 43–74%），五年无事件概率为11%（95% CI 3–28%）。患者队列的并发症发生率为54%。非骨水泥假体固定与统计学上显著更优的功能结果相关。此外，较高的体重和较大的患者年龄与较低的MSTS评分相关。 结论：与生物学重建相比，需要快速再活动或辅助放射治疗的患者可能从骨干假体中获益更多。然而，骨干假体的并发症和翻修率较高。所选择的固定方式对功能结果显示出统计学上的显著影响。
肿瘤(癌症)患者之家