CAJ | 학술논문

目的：探讨带翼髋臼加强杯在髋臼周围肿瘤切除术后髋臼重建中的应用。方法回顾分析2006年3月至2011年3月期间应用带翼髋臼加强杯联合人工全髋关节置换术对15例HarringtonⅢ型髋臼周围肿瘤行手术治疗患者的临床资料，其中男9例，女6例，年龄26～65岁（平均45.3岁），包括I级软骨肉瘤6例、骨巨细胞瘤5例、软骨母细胞瘤2例、肺癌骨转移1例、乳腺癌骨转移1例。结果本组病例术中出血量500～2600 ml（平均1130 ml），手术时间156～262 min（平均185 min），住院时间15～32 d（平均22.8 d），术后随访时间12～60个月（平均27.1个月）；术后1例出现手术切口血肿，1例腘静脉血栓，1例患者发生坠积性肺炎，1例术后15 d出现髋关节脱位，1例病例术后22个月因骨巨细胞瘤复发导致假体松动；术后髋臼外展角40°～55°，平均47.8°；术后12周MSTS评分17～27分，平均23.4分；VSA评分0～5分，平均（2.3±1．0）分；Harris评分62～89分，平均（71.2±6.8）分；1例术后18个月死于肺腺癌进展期，1例骨巨细胞瘤术后20个月发现复发，1例Ⅰ软骨肉瘤术后33个月发现复发。结论应用带翼髋臼加强杯联合人工全髋关节置换术治疗Harrington Ⅲ型髋臼周围肿瘤安全、可靠，术后髋关节功能恢复良好。
목적：탐토대익관구가강배재관구주위종류절제술후관구중건중적응용。방법회고분석2006년3월지2011년3월기간응용대익관구가강배연합인공전관관절치환술대15례HarringtonⅢ형관구주위종류행수술치료환자적림상자료，기중남9례，녀6례，년령26～65세（평균45.3세），포괄I급연골육류6례、골거세포류5례、연골모세포류2례、폐암골전이1례、유선암골전이1례。결과본조병례술중출혈량500～2600 ml（평균1130 ml），수술시간156～262 min（평균185 min），주원시간15～32 d（평균22.8 d），술후수방시간12～60개월（평균27.1개월）；술후1례출현수술절구혈종，1례객정맥혈전，1례환자발생추적성폐염，1례술후15 d출현관관절탈위，1례병례술후22개월인골거세포류복발도치가체송동；술후관구외전각40°～55°，평균47.8°；술후12주MSTS평분17～27분，평균23.4분；VSA평분0～5분，평균（2.3±1．0）분；Harris평분62～89분，평균（71.2±6.8）분；1례술후18개월사우폐선암진전기，1례골거세포류술후20개월발현복발，1례Ⅰ연골육류술후33개월발현복발。결론응용대익관구가강배연합인공전관관절치환술치료Harrington Ⅲ형관구주위종류안전、가고，술후관관절공능회복량호。
Objective To evaluate the surgical procedure of the winged protrusio cages in reconstructing pelevic defect after acetabular tumor resection .Methods The medical records of 15 patients with Harrington Ⅲ acetabular tumor who underwent reconstruction with a winged protrusio cages and total hip arthroplasty ( THA) were reviewed .There were nine males and six females with an average age of 45.3 years (range, 26 -65 years).Including six cases of grade I chondrosarcoma , five cases of giant cell tumor , two cases of chondroblastoma , one case of metastasis of lung adenocarcinoma , one case of metastasis of ductal breast cancer .The average follao-up time was 27.1 months (range, 12-60 months). Results The average blood loss was 1130 ml (range, 500-2600 ml).The average surgical time was 185 minutes (range, 156-262 minutes).The average surgical hospital stay was 22.8 days (range, 15-32 days).There were one case of hematoma , one case of popliteal vein thrombosis and one case of pulmonary infection after the surgical procedure , one case of dislocation on the 15th day after the surgery , and one case of the implant loosening with the local tumor recurrence on 22 th month after the surgery .The average acetabular abduction angle was 47.8°( range, 40°-55°).The average MSTS score was (23.4 ±3.4) (range, 17-27).The average VAS score was (2.3 ±1.0) (range, 0-5).The average Harris score was (71.2 ±6.8) (range, 62 -89).One patient died with advanced lung adenocarcinoma in the 18th month.One case of recurrence of the giant cell tumor and one case of grade Ⅰ chondrosarcoma were detected in the 20 th month and the 33 th month respectine .Conclusion The surgical procedure of winged protrusio cages and THA in reconstructing pelevic defect after Harrington Ⅲ acetabular tumor resection is safe, reliable and with good functional outcome .