摘要
目的评价旋转铰链型人工膝关节置换治疗膝关节周围骨巨细胞瘤的疗效。方法自2001年1月至2008年1月收治膝关节周围骨巨细胞瘤31例,男性13例,女性18例,年龄19～56岁,平均33.5岁。股骨远端20例,胫骨近端11例。Companacci分级,Ⅱ级7例,Ⅲ级24例。肿瘤已穿破骨皮质或侵犯至关节软骨下者2例,已发生病理性骨折者3例,瘤组织病理检测具有较强的侵袭性者5例,已有一次或多次复发者21例。所有患者行瘤段切除、旋转铰链型人工膝关节置治疗。结果随访12～96个月,所有患者无局部复发或远处转移。患者MSTS评分为17.0～27.0(24.0±2.5)分,肢体功能优23例,良6例,中2例,优良率为93.5%。结论旋转铰链型人工膝关节置换是治疗膝关节周围骨巨细胞瘤的有效方法 ,能减少局部复发及提高临床效果。
Objective To evaluate the clinical effectiveness of rotatory hinge prosthesis replacement for treatment of giant cell tumors around knee joint. Methods Thirty-one patients with giant cell tumors of bone around the knee from January 2001 to January 2008 in our hospital were reviewed. There were 13 males and 18 females. Their ages ranged from 19 to 56 and the mean age was 33.5. The anatomic site for the lesions were the distal femur （20 cases） and proximal tibia （11 cases）. Using Companacci’s staging system： 7 patients were classified as grade Ⅱ and 24 as grade Ⅲ. The patients were grouped as follows： the tumor breaking through the cortex with an extraosseous mass in 2 patients,having pathologic fracture in 3,representing more biologically-aggressive lesions in 5,and having one or more local recurrences in 21. All patients had been treated with en block excision and reconstruction with rotatory hinge prosthesis. Results According to the follow-up for 12 to 96 months,all patients had no local recurrence or metastasis. The mean Musculoskeletal Tumor Society （MSTS） score was 24.0±2.5,with an excellent limb function in 23 patients,good in 6 patients,and fair in 2 patients. The overall excellent and good function was obtained in 93.5% of the patients. Conclusion Rotatory hinge prosthesis replacement is an effective method to treat giant cell tumors of bone around the knee joint. It also can reduce the local recurrence and obtain better the outcomes.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第14期1560-1562,共3页
Journal of Third Military Medical University
关键词
膝关节
骨巨细胞瘤
关节置换
knee joint
giant cell tumors of bone
joint replacement
作者简介
[通信作者]陈飚，电话：（023）65301786，E-mail：ehenbiao1179@sina．com
