人工肿瘤假体置换治疗近关节部位软骨肉瘤  

Treatment of artificial joint prosthetic replacement for chondrosarcomas near the joints

作　　者：孙文星[1] 杨昊飞 张景义[1] 梅伟[2] SUN Wenxing;YANG Haofei;ZHANG Jingyi;MEI Wei(Department II of Bone disease and bone tumors,Zhengzhou Orthopaedic Hospital,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州市骨科医院骨病骨肿瘤Ⅱ科,450052 [2]郑州市骨科医院脊柱外科,450052

出　　处：《中国骨科临床与基础研究杂志》2017年第6期344-348,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的评价人工肿瘤假体置换治疗近关节部位软骨肉瘤的临床效果。方法对2014年5月至2017年1月郑州市骨科医院收治的39例邻近关节部位组织恶性程度为低度和中度的软骨肉瘤患者行瘤段广泛切除和人工肿瘤假体置换重建治疗,其中旋转铰链型膝关节假体置换8例、肱骨头假体置换9例、髋关节假体置换13例、半骨盆假体置换6例、全股骨置换3例。结果 39例患者均获随访,随访时间6~35个月(平均22.5个月),无局部复发或远处转移。末次随访时美国骨肿瘤学会(MSTS)评分为(23.2±3.1)分(15~27分),肢体功能优27例、良4例、中3例、差5例,优良率为79%。结论人工肿瘤假体置换是治疗邻近关节部位低度和中度恶性软骨肉瘤的有效保肢疗法,可尽量保留关节功能,提高临床效果。Objective To evaluate the clinical effect of artificial prosthetic replacement for treatment of chondrosarcomas near the joints.Methods A total of 39 patients who dignosed as chondrosarcomas near the joints with low or moderate malignancy were treated by en block excision and reconstruction with artificial joint prosthetic replacement in Zhengzhou Orthopaedic Hospital from May 2014 to January 2017.The types of the joint prostheses were as follows:rotating hinge knee prosthesis in 8 cases,artificial humeral head in 9,hip prosthesis in 13,hemi-pelvic prosthesis in 6,and total femur prosthesis in 3 cases.Results The follow-up was 22.5 months(6 to 35 months).No patients were found local recurrence or remote metastasis.The Musculoskeletal Tumor Society(MSTS)score was 15-27(23.2±3.1)at the latest follow-up,with an excellent and good rate of limb function was 79%(excellent in 27,good in 4,fair in 3 and poor in 5 cases).Conclusions Artificial joint prosthetic replacement is an effective limb salvage method for treatment of chondrosarcomas near the joints with low or moderate malignancy,which could save the function of joints as much as possible,and provide better clinical effects.

关 键 词：软骨肉瘤 假体和植入物 人工关节 关节成形术 置换 

分 类 号：R738.3[医药卫生—肿瘤] R687.42[医药卫生—临床医学]