Erol YALNIZ, MERT ÇİFTDEMİR, Serdar MEMİŞOĞLU

Tümör rezeksiyon protezi uygulanan kemik tümörlü olgularda fonksiyonel sonuçlar

Amaç: Bu çalışmada çimentolu modüler tümör rezeksiyon protezi ile tedavi edilen ekstremite kemik tümörlü olguların fonksiyonel sonuçları değerlendirildi. Çalışma planı: Kemik tümörlerine yönelik geniş rezeksiyon ve çimentolu tümör endoprotezi ile rekonstrüksiyon uygulanan 23 hasta (12 erkek, 11 kadın; ort. yaş 49; dağılım 14-81) incelendi. On iki hastada (%52.2; ort. yaş 63.5) metastatik, 11’inde (%47.8; ort. yaş 38) primer tümör vardı. Tümörler en sık femurda (n=17) görüldü; beş olguda humerus tutulumu vardı. Tüm olgularda çimentolu TMTS (Turkish Musculoskeletal Tumor Society) tümör rezeksiyon protezleri kullanıldı. Fonksiyonel sonuçlar MSTS (Musculoskeletal Tumor Society) skorlama sistemi ile değerlendirildi. Ortalama takip süresi 24 ay (dağılım 1-108 ay) olarak belirlendi (primer tümörlü grupta 30 ay; metastatik tümörlü grupta 3 ay). Sonuçlar: Yedi hastada (%30.4) ameliyat sonrası dönemde komplikasyon gelişti. Bunların üçü lokal nüks idi. Takip dönemi içinde 11 hasta tümöre bağlı nedenlerle kaybedildi; üç hastada uzak metastaz gelişti; dokuz hastada ise tümör bulgusuna rastlanmadı. Sağkalım primer tümörlü grupta anlamlı derecede fazlaydı (p

Anahtar Kelimeler:

Protez implantasyonu, Protezler ve implantlar, Tedavi sonucu, Geriyedönük çalışma, Ameliyat sonrası komplikasyonlar, Neoplazm nüksü, lokal, Neoplazm metastazı, Kemik neoplazmları, Kol ve bacak kurtarılması, Femoral neoplazmlar, Rekonstrüktif cerrahi işlemler, Hastalıksız sağkalım, Yürüme

Functional results of patients treated with modular prosthetic replacement for bone tumors of the extremities

Objectives: We evaluated functional results of patients who were treated with cemented modular prosthetic replacement for bone tumors of the extremities. Methods: The study included 23 patients (12 males, 11 females; mean age 49 years; range 14-81 years) who underwent wide resection and cemented endoprosthetic replacement with the TMTS (Turkish Musculoskeletal Tumor Society) prosthesis for bone tumors. Twelve patients (52.2%; mean age 63.5 years) had metastatic, 11 patients (47.8%; mean age 38 years) had primary tumors. The most common site of involvement was the femur (n=17), followed by the humerus (n=5). Functional evaluations were made with the Musculoskeletal Tumor Society (MSTS) scoring system. The mean followup period was 24 months (range 1 to 108 months), being 30 months for primary, and 3 months for metastatic tumors. Results: Postoperative complications were seen in seven patients (30.4%), being local recurrences in three patients. During the follow-up period, 11 patients died due to tumoral causes, distant metastasis developed in three patients, and nine patients were tumor-free. Survival was significantly better in patients with primary tumors (p<0.001). All the patients were able to walk without crutches in the postoperative period. The mean MSTS score was 58.9% (range 40% to 90%) in survivors, which was 71.5% (range 60% to 90%) for primary tumors, and 47.4% (range 40% to 73%) for metastatic tumors (p<0.001). Conclusion: Reconstruction with cemented modular endoprostheses is an appropriate surgical alternative in the treatment of large segmental defects after resection of extremity tumors, with satisfactory functional results particularly in primary tumors.

Keywords:

Prosthesis Implantation, Prostheses and Implants, Treatment Outcome, Retrospective Studies, Postoperative Complications, Neoplasm Recurrence, Local, Neoplasm Metastasis, Bone Neoplasms, Limb Salvage, Femoral Neoplasms, Reconstructive Surgical Procedures, Disease-Free Survival, Walking,

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