半膝关节假体置换与半膝骨关节移植保肢治疗膝关节恶性骨肿瘤的12例2组对照比较  

Semi-knee-osteoarticular allograft versus semi-knee-joint prosthesis replacement for malignant tumors:Control study of 12 cases

作　　者：袁涛[1] 许建波[1] 许哲源[2] 孙洪瀑[1] 肖砚斌[1] 赵敏[3] 杨祚璋[1] 史会明[1] 

机构地区：[1]昆明医学院第三附属医院(云南省肿瘤医院),骨科,云南省昆明市650118 [2]昆明医学院附属昆华医院,云南省昆明市650118 [3]昆明医学院第三附属医院(云南省肿瘤医院)病案科,云南省昆明市650000

出　　处：《中国组织工程研究与临床康复》2008年第48期9523-9527,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：2001-07/2007-06昆明医学院第三附属医院(云南省肿瘤医院)骨科纳入膝关节周围恶性骨肿瘤患者12例,骨巨细胞瘤2例,肺癌骨转移癌1例,骨肉瘤9例。根据治疗方案分为2组,同种异体半膝骨关节移植保肢组6例,移植骨段长度12～18cm,平均14.8cm;移植后随访1.3～5.7年,平均4.2年;疗效优良率为50%。个体化人工半膝关节假体置换保肢组6例,假体体部长度12～15cm,平均13.6cm;1例患者失访,其余5例患者置换后随访0.4～5.5年,平均3.9年;疗效优良率为80%。两组患膝关节国际保肢学会功能评分差异无显著性意义(P>0.05)。半膝同种异体骨关节移植组患者的术后并发症发生率明显高于人工半膝关节假体置换组(66.7%,20.0%,P<0.05)。提示同种异体半膝关节移植和人工半膝关节假体置换是治疗膝关节周围恶性肿瘤的两种较为满意的保肢方法,其中个体化人工半膝关节假体置换优于同种异体半膝关节移植。From July 2001 to June 2007, 12 patients with malignant tumors around knee were selected from Department of Orthopaedics, Third Hospital of Kunming Medical College, including 2 cases of giant cell tumor of bone, 1 of metastatic tumor from lung, and 9 of osteosarcoma. They were divided into two groups. The senti-knee-osteoarticular allograft （n=6）： the length of bone allograft was 14.8 cm （range 12-18 cm）; they were followed up for 4.2 years （1.3 to 5.7 years） with excellent and good rate of 50%. The semi-knee- joint prosthesis replacement group （n=6）： the length of prosthesis was 13.6 cm （range 12-15 cm）; except for one lost, all patients were followed up for 3.9 years （range 0.4-5.5 years） with excellent and good rate of 80%. The limb function was evaluated by ISOLS standard, and there were no differences in scores between two groups （P 〉 0.05）. The incidence of postoperative complications was significantly greater in semi-knee-osteoarticular allograft group than semi-knee-joint prosthesis replacement group （66.7%, 20.0%, P 〈 0.05）. The results of the study indicate that semi-knee-osteoarticular allograft and semi-knee-joint prosthesis replacement are two satisfactory limb salvage treatments for malignant tumors around knee. Moreover, semi-knee-joint prosthesis replacement is superior over semi-knee-osteoarticular allograft.

关 键 词：半膝关节 假体置换 骨关节移植 骨肿瘤 保肢 

分 类 号：R681[医药卫生—骨科学]