肿瘤型假体无菌性松动的治疗现状-中国骨与关节杂志.PDF

. 540 . 中国骨与关节杂志 2014 年 7 月第 3 卷第 7 期 Chinese Journal of Bone and Joint, July 2014, Vol 3, No.7 . 综述 Review . 肿瘤型假体无菌性松动的治疗现状 高明　张清　牛晓辉 DOI: 10.3969/j.issn.2095-252X.2014.07.013　　中图分类号：R738.1 作者单位：100035　北京积水潭医院骨肿瘤科 Current status of the treatment of aseptic loosening in tumor prostheses GAO Ming, ZHANG Qing, NIU Xiao-hui. Department of Orthopaedic Oncology, Beijing Jishuitan Hospital, Beijing, 100035, PRC Abstract Aseptic loosening ( AL ) is one of the most common complications in tumor prostheses. Loss 【 】 of bone quantity and decline of bone quality are the main challenges that orthopedists encounter when they deal with AL. Based on the latest reports, prosthesis revision is the primary choice in the treatment of AL, and it can provide relatively satisfactory outcomes when compared with other methods. While it needs enough bone quantity and good bone quality for prosthetic stability. In some reports, it can get a median Musculoskeletal Tumor Society ( MSTS ) functional score of 96% ( range: 50%-100% ) after an average follow-up of 101 months ( range: 47-155 months ) after the surgery. Besides this, allograft-prosthesis composites ( APCs ) are another choice. Allograft segments are used to construct a certain fixation arm to get a more stable fixation. However, its outcomes are not as satisfactory as that of prosthesis revision. According to some reports, after an average follow-up of 59 months after the surgery, it can provide an average MSTS functional score of 62% ( range: 57%-67% ). While we must take account that these patients receiving APCs always have less bone quantity and worse bone quality, when compared with those only receiving prosthetic treatment. In recent years, a new type of prosthesis based on extra-cortical plate fixation has been used in the revision, which is superior to the conven