游离髌骨移植修复骨巨细胞瘤术后膝关节缺损  

The clinical analysis of free patellar implantation in repairing the defect of the knee of giant cell tumors

作　　者：常楚[1] 王玉锋[1] 王星铎[1] 原银栋[1] 

机构地区：[1]中国医科大学附属第一医院骨科,沈阳110001

出　　处：《中华外科杂志》2004年第12期754-756,共3页Chinese Journal of Surgery

摘　　要：目的　探讨游离髌骨移植对股骨下端或胫骨上端骨巨细胞瘤患者膝关节缺损的修复治疗效果。方法　本组共 9例股骨下端或胫骨上端骨巨细胞瘤患者 ,肿瘤侵袭关节软骨造成膝关节缺损 ,采用游离髌骨移植术对膝关节缺损进行修复。结果　患者随访 3～ 12 1个月 ,平均 6 5个月 ,无 1例复发转移 ,膝关节功能经综合评价效果优良 (8/ 9) ;膝关节屈伸活动范围 70°～ 12 0° ,平均 90° ;股四头肌肌力均达到 5级。1例患者术后 9年出现髌骨退行性改变。结论　对侵袭关节软骨的股骨下端或胫骨上端骨巨细胞瘤患者 ,行包括肿瘤在内的髁部大块切除后 ,游离髌骨移植是一种可行的膝关节修复方法。Objective To analysis the clinical effects of free patellar implantation in treating the defect of the knee joint after the excision of giant cell tumor in the distal femur and the proximal tibia. (Methods If the giant cell) tumor in the distal femur and the proximal tibia invaded the articular surface, we resected the condyle of femur or tibia including the tumor,dissociated the patella and placed it in the condyle horizontally to repair the articular surface.The cruciate ligament was reserved in all the patients.The condyle of femur or tibia was replaced by the anterior surface or the articular surface of the patella respectively.The implanted patella was fixed by the screw to the contralateral condyle,and the remaining defect was filled by autogenous cancellous illium. Results Nine patients were followed up 3 to 121 months ,the average was 65 months.None of them recurred or metastated.The excellent and good rate of the functional evaluation of knee joints was 88.9%. Conclusion After resecting the condyle of femur or tibia including the tumors which invade the articular surface,we find that free patellar implantation is a suitable way to repair the defect of the knee.

关 键 词：游离髌骨移植 修复 骨巨细胞瘤 术后 膝关节缺损 

分 类 号：R738.1[医药卫生—肿瘤]