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首页> 外文期刊>Artificial Organs >Postoperative Ambulatory Performance Status Significantly Affects Implant Failure Rate Among Surgical Treatment Strategies in Patients With Proximal Femur Metastasis
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Postoperative Ambulatory Performance Status Significantly Affects Implant Failure Rate Among Surgical Treatment Strategies in Patients With Proximal Femur Metastasis

机译：术后动态性能状态显着影响近端股骨转移患者的手术治疗策略中的植入物失效率

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Surgical treatment strategies for proximal femur metastasis have been reported with mixed results. Little is known about risk factor for implant failure except for longer patient survival. Therefore, we determined whether implant survivorship differed among treatment strategies, as well as risk factors for implant failure. We retrospectively reviewed a consecutive 106 patients with proximal femur metastasis treated with prosthesis replacement (n = 38), intramedullary nail (n = 32), and dynamic hip screw (DHS) (n = 36). Eastern Cooperative Oncology Group (ECOG) scale and Karnofsky index were used to evaluate functional outcome. Patient characteristics and postoperative ambulatory performance status were assessed for their values in determining implant failure. Overall implant failure rate was 11.3% (12 of 106). Prosthesis replacement was related to better implant survivorship (P = 0.041), without mechanical failures. On the contrary, 7 of the 10 implant failures in the fixation group were considered mechanical failures. Better postoperative ambulatory status (ECOG <= 2) was a risk factor for implant failure (P = 0.03). Notably, for patients with poor ambulatory status (ECOG >= 3), implant survivorship was not different among choice of implants. In conclusion, prosthesis replacement would be a more durable option in the treatment of proximal femur metastasis. Postoperative ambulatory status could be an additional consideration. For patients with poor expected ambulatory performance status, fixation with intramedullary nail or DHS might be considered for a less technical demanding procedure.
机译：报告了近端股骨转移的外科治疗策略。对于植入物衰竭的危险因素，少许令人着称，除了更长的患者存活。因此，我们确定植入物生存是在治疗策略中不同的植入物，以及植入物失败的危险因素。我们回顾性地审查了连续的106例患有假体替代（n = 38）的近端股骨转移的患者（n = 38），髓内钉（n = 32）和动态髋螺钉（DHS）（n = 36）。东方合作肿瘤组（ECOG）规模和Karnofsky指数用于评估功能结果。评估患者的特征和术后动态性能状态在确定植入物衰竭时的价值。整体植入物失效率为11.3％（106个中的12个）。假体替代与更好的植入物生存（P = 0.041）有关，没有机械故障。相反，固定组10种植入失败中的7个被认为是机械故障。更好的术后动态状态（ECOG <= 2）是植入物失败的危险因素（P = 0.03）。值得注意的是，对于患有差的动态地位（ECOG> = 3）的患者，植入物的植入物在植入物的选择方面并不不同。总之，假体替代是一种更耐用的选择，治疗近端股骨转移。术后动态状态可能是一个额外的考虑因素。对于预期预期的患者患者，采用较差的动态性能状态，可以考虑使用髓内钉或DHS的固定，以获得更少的技术要求苛刻的程序。

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