旋转铰链型膝关节置换术在膝部骨肿瘤中应用的临床研究  

Clinical research on rotating hinge prosthesis knee replacement for the treatment of bone tumors around the knee

作　　者：王永贵[1] 刘江涛[1] 

机构地区：[1]湖北医药学院附属襄阳医院骨科,湖北襄阳441000

出　　处：《中国医药导报》2013年第7期85-87,90,共4页China Medical Herald

摘　　要：目的探讨旋转铰链型人工膝关节置换术在膝部骨肿瘤中应用的疗效。方法选择2009年7月～2012年6月湖北医药学院附属襄阳医院行手术治疗的膝部良恶性骨肿瘤患者32例,其中股骨远端18例,胫骨近端14例,分别是骨肉瘤17例,骨巨细胞瘤12例,骨巨细胞瘤合并动脉瘤样骨囊肿3例。骨肉瘤患者术前均接受1～2个疗程新辅助化疗,术后继续3～4个疗程正规化疗。观察术后Enneking肢体功能评分、影像学评价。结果所有患者均得到随访,随访12～36个月(平均24个月);未见肿瘤复发、假体松动;1例术后出现肢端麻木;1例术后出现感染;股骨下端组Enneking肢体功能评分平均24.7分;胫骨上端组平均24.1分。结论旋转铰链型膝关节置换术是治疗膝部良恶性骨肿瘤较理想的保肢方法。Objective To study the operative methods and effects of limb salvage with rotating hinge prosthesis replacement for bone tumors around the knee. Methods 32 cases of benign and malignant bone tumors around knee treated surgically from July 2009 to June 2012 in Affiliated Xiangyang Hospital of Hubei Medical Collage were selected. In the study, the location of tumors were found at distal femur in 18 cases and at proximal tibia in 14 cases. In all 32 cases, 17 cases of osteosarcoma were found, 12 cases of giant cell tumor of bone were found, 3 cases of giantcelltumor of bone combine with aneurysmal bone cyst were found. 1-2 cycles of neoadjuvant chemotherapy were accepted by osteosarcoma patients before surgery, and 3-4 regular course of chemotherapy were continued after the surgery. En- neking of Limb function score and imaging evaluation were observed. Results All the patients were followed-up for 12-36 months with average follow-up period of 24 months. No tumor recurrence and loosening of the prosthesis was found; 1 case of postoperative numbness of extremities was found, 1 case of postoperative infection was found. The average Enneking Limb function score of distal femur group were 24.7, the average Enneking limb function score of proximal tibia guoup were 24.1. Conclusion Rotating hinge knee replacement surgery is the ideal knee for benign and malignant bone tumor limb salvage.

关 键 词：骨肿瘤 股骨下端 胫骨上端 旋转铰链式膝关节 

分 类 号：R738.1[医药卫生—肿瘤]