腘绳肌腱重建髌腱在胫骨近端肿瘤瘤段切除肿瘤式膝关节假体置换术中的应用  

Application of hamstring tendon for patellar tendon reconstruction in segment resection of the tumor of the proximal tibial and tumor-type knee prosthesis replacement

作　　者：董辉详[1] 黄长明[1] 范华强[1] 张少战[1] 

机构地区：[1]厦门大学附属成功医院(解放军第174医院)骨科,福建厦门361003

出　　处：《中国骨与关节损伤杂志》2017年第8期804-807,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨腘绳肌腱重建髌腱在胫骨近端肿瘤瘤段切除肿瘤式膝关节假体置换术中的应用。方法笔者自2008-06—2015-06采用肿瘤式膝关节假体置换术治疗20例胫骨近端侵蚀性肿瘤,使用腘绳肌腱移植重建切除的髌韧带,腓肠肌内侧头旋转覆盖假体及重建后髌腱,牢固重建伸膝装置,评估术后临床疗效。结果本组20例均获得随访12~80个月,平均30个月。术后6个月下肢功能采用Enneking肢体肌肉骨骼肿瘤外科治疗重建置换术后膝关节功能评估标准评定:优16例,良4例。1例骨肉瘤患者复发,复发率为5%,后给予截肢,随访第3年死亡;其余患者无局部复发或远处转移迹象。本组无感染、腓总神经损伤等并发症。结论腘绳肌腱重建髌腱在胫骨近端肿瘤瘤段切除肿瘤式膝关节假体置换术中的应用效果良好,能很好重建伸膝装置,是一种安全、可靠的选择。Objective To analyze the application of patellar tendon reconstruction using hamstring tendon in segment resection of the tumor of the proximal tibial and knee replacement of tumor prosthesis. Methods From June 2008 to June2015, 20 patients underwent tumor-type knee prosthesis replacement for the treatment of proximal tibial erosion tumor. The hamstring tendon graft was used for reconstruction of the resected patellar tendon, the medial head of the gastrocnemius muscle was used to cover the prosthesis and reconstruct the patellar tendon, solid reconstruction of knee extension apparatus.The clinic efficacy was evaluated after operation. Results The results of the 20 patients were followed up. The follow-up time was about 12-80 months, average 30 months. Six months after surgery, patients received Enneking knee function evaluation,lower extremity function was excellent in 16 cases, good in 4 cases. The recurrence occurred in one osteosarcoma patient, the recurrence rate was 5%, then the patient was amputed. The patient died in the third follow-up year. No evidence of local recurrence or distant metastasis in other patients was found. There were no infection, peroneal nerve injury and other complications. Conclusion The application of hamstring tendon for patellar tendon reconstruction in segment resection of the tumor of the proximal tibial and tumor-type knee prosthesis replacement can reconstruct knee extensor device very well,which is safe and reliable.

关 键 词：骨肿瘤 腘绳肌腱 髌腱 假体置换 

分 类 号：R687.3[医药卫生—骨科学]