CAJ | 학술논문

目的观察定制旋转铰链式膝关节假体置换治疗膝关节周围侵袭性骨肿瘤患者的临床疗效.方法回顾性分析2000年1月至2005年1月收治的27例膝关节周围侵袭性骨肿瘤患者的临床资料,其中股骨远端肿瘤13例,胫骨近端肿瘤14例;包括骨巨细胞瘤16例、骨肉瘤9例、滑膜肉瘤1例、恶性纤维组织细胞瘤1例.所有患者进行肿瘤切除、定制旋转铰链式膝关节假体置换治疗,术后进行康复治疗,恶性肿瘤患者进行常规化疗.术后随访,参照国际骨与软组织肿瘤协会(MSTS)评分标准进行膝关节功能评分.结果所有患者随访11～122个月,中位时间64.5个月.术后6个月随访所有患者生存,MSTS评分为(22.2±3.5)分,膝关节功能优良率为81.5%(22/27).近期随访23例患者生存,4例患者死亡,4例发生与假体相关的并发症;其中22例生存患者MSTS评分为(21.0±2.3)分,膝关节功能优良率为72.7%(16/22).本组患者治疗后5年生存率为85.2%(23/27).结论应用定制旋转铰链式膝关节假体置换治疗膝关节周围侵袭性骨肿瘤能获得良好的治疗效果.
목적 관찰정제선전교련식슬관절가체치환치료슬관절주위침습성골종류환자적림상료효.방법 회고성분석2000년1월지2005년1월수치적27례슬관절주위침습성골종류환자적림상자료,기중고골원단종류13례,경골근단종류14례;포괄골거세포류16례、골육류9례、활막육류1례、악성섬유조직세포류1례.소유환자진행종류절제、정제선전교련식슬관절가체치환치료,술후진행강복치료,악성종류환자진행상규화료.술후수방,삼조국제골여연조직종류협회(MSTS)평분표준진행슬관절공능평분.결과 소유환자수방11～122개월,중위시간64.5개월.술후6개월수방소유환자생존,MSTS평분위(22.2±3.5)분,슬관절공능우량솔위81.5%(22/27).근기수방23례환자생존,4례환자사망,4례발생여가체상관적병발증;기중22례생존환자MSTS평분위(21.0±2.3)분,슬관절공능우량솔위72.7%(16/22).본조환자치료후5년생존솔위85.2%(23/27).결론 응용정제선전교련식슬관절가체치환치료슬관절주위침습성골종류능획득량호적치료효과.
Objective To evaluate the clinical efficacy of knee joint replacement with patienttailored rotating hinge prosthesis in patients with invasive perigenual bone tumor.Methods Between January 2000 and January 2005, clinical data of 27 patients with invasive perigenual bone tumor were retrospectively analyzed, including 13 cases of distal femoral tumor and 14 of proximal tibial tumor,comprising 16 cases of giant cell tumors, 9 of osteosarcomas, 1 of synovial sarcomas and 1 of malignant fibrous histiocytomas.All the patients received resection of the tumor, knee-joint replacement with patienttailored rotating hinge prosthesis and postoperative rehabilitation.Patients with malignant tumor also underwent routine chemotherapy after surgery.MSTS scoring was used to evaluate the knee joint function in patients during the postoperative follow-up.Results All the patients were followed up for 11 to 122 months, with median time of 64.5 months.All the patients survived 6 months of follow-up, with a mean MSTS score of 22.2±3.5 and the rate of good knee joint function being 81.5% (22/27).In a recent follow-up, 23 patients were alive and 4 patients dead.Prosthesis-related complications developed in 4 patients.The mean MSTS score was 21.0 ±2.3, and the rate of good knee joint function was 72.7% (16/22) in 22 surviving patients.The overall rate of survival in all the patients was 85.2% (23/27) at five years after treatment.Conclusion The knee-joint replacement with patient-tailored rotating hinge knee prosthesis is associated with a good efficacy in treatment of invasive perigenual bone tumor.