医学
骨不连
外科
假肢
生存曲线
置信区间
吸收
牙科
内科学
癌症
作者
George C. Babis,Vasileios I. Sakellariou,Mary I. O’Connor,Arlen D. Hanssen,Franklin H. Sim
出处
期刊:The journal of bone and joint surgery
[British Editorial Society of Bone & Joint Surgery]
日期:2010-03-01
卷期号:92-B (3): 349-355
被引量:73
标识
DOI:10.1302/0301-620x.92b3.23112
摘要
We report the use of an allograft prosthetic composite for reconstruction of the skeletal defect in complex revision total hip replacement for severe proximal femoral bone loss. Between 1986 and 1999, 72 patients (20 men, 52 women) with a mean age of 59.9 years (38 to 78) underwent reconstruction using this technique. At a mean follow-up of 12 years (8 to 20) 57 patients were alive, 14 had died and one was lost to follow-up. Further revision was performed in 19 hips at a mean of 44.5 months (11 to 153) post-operatively. Causes of failure were aseptic loosening in four, allograft resorption in three, allograft nonunion in two, allograft fracture in four, fracture of the stem in one, and deep infection in five. The survivorship of the allograft-prosthesis composite at ten years was 69.0% (95% confidence interval 67.7 to 70.3) with 26 patients remaining at risk. Survivorship was statistically significantly affected by the severity of the pre-operative bone loss (Paprosky type IV; p = 0.019), the number of previous hip revisions exceeding two (p = 0.047), and the length of the allograft used (p = 0.005).
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