CAJ | 학술논문

背景：股骨远端是原发性骨肿瘤的好发部位，目前大部分都选用保肢治疗。国内外有很多关于股骨远端肿瘤型人工膝关节假体早期和中期功能及预后的报道，但对其长期功能及预后的报道尚少。 　　目的：探讨行国产型股骨远端肿瘤型旋转铰链式膝关节假体置换后患者的假体长期预后情况及肢体功能。 　　方法：回顾性分析2000年1月至2008年6月安徽医科大学第一附属医院骨科收治的股骨远端恶性骨肿瘤患者34例，均采用旋转铰链式人工假体置换。 　　结果与结论：34例患者平均随访时间62.4个月(11-126个月)，末次随访23例患者生存，11例患者死亡；23例生存患者中7例发生与假体相关并发症：4例行翻修，3例行截肢。肿瘤型膝关节假体的患者5年生存率为67.6%；29例患者在置换后2年时行膝关节Enneking评分，总体平均分为19.3分(7-27分)：优6例，良16例，中5例，差2例，患者假体功能总的优良率为75.9%。结果提示，旋转铰链式人工假体置换在治疗股骨远端恶性骨肿瘤中能获得满意的肢体功能和患者长期生存率。
배경：고골원단시원발성골종류적호발부위，목전대부분도선용보지치료。국내외유흔다관우고골원단종류형인공슬관절가체조기화중기공능급예후적보도，단대기장기공능급예후적보도상소。 　　목적：탐토행국산형고골원단종류형선전교련식슬관절가체치환후환자적가체장기예후정황급지체공능。 　　방법：회고성분석2000년1월지2008년6월안휘의과대학제일부속의원골과수치적고골원단악성골종류환자34례，균채용선전교련식인공가체치환。 　　결과여결론：34례환자평균수방시간62.4개월(11-126개월)，말차수방23례환자생존，11례환자사망；23례생존환자중7례발생여가체상관병발증：4례행번수，3례행절지。종류형슬관절가체적환자5년생존솔위67.6%；29례환자재치환후2년시행슬관절Enneking평분，총체평균분위19.3분(7-27분)：우6례，량16례，중5례，차2례，환자가체공능총적우량솔위75.9%。결과제시，선전교련식인공가체치환재치료고골원단악성골종류중능획득만의적지체공능화환자장기생존솔。
BACKGROUND:Distal femur is a predilection site for primary bone tumors, most of which are treated with salvage treatment. There are many reports on the early-stage, mid-term and prognosis of the distal femur tumor-type artificial knee joint prosthesis, but reports on long-term function and prognosis are less. OBJECTIVE:To study the long-term prognosis and limb function after treatment with rotating-hinge knee prosthesis. METHODS:Thirty-four patients with distal femoral bone tumors admitted to the Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University between January 2000 and June 2008 were retrospectively analyzed, including 19 males and 15 females. Al patients were subjected to rotating hinge knee prosthesis replacement. RESULTS AND CONCLUSION:The mean fol ow-up period was 62.4 months (range 11 to 126 months). At the final of fol ow-up, 23 patients were event-free alive and 11 patients were dead. Seven of 23 survival patients suffered from prosthesis related complications, including four cases of prosthesis revision and three cases of amputation. The event-free survival rate of 23 patients undergoing replacement of domestic tumor prosthesis around the knee was 67.6%in 5 years. The mean functional score of affected limb was 19.30 (7 to 27 points):excellent in 6 cases, good in 16, fine in 5 and poor in 2. The excellent-good rate was 75.9%. The clinical outcomes suggested that the satisfactory limb function and survival rate could be achieved with the application of domestic tumor prosthesis replacement for treatment of malignant bone tumors around the knee.