组配式假体置换与3D打印钽块植入治疗胫骨近端Ⅲ级原发性骨巨细胞瘤的效果比较  

Comparison of the Effects of Combination Prosthesis Replacement and Three-Dimensional Printed Tantalum Block Implantation in the Treatment of GradeⅢPrimary Giant Cell Tumors of the Proximal Tibia

作　　者：成小辉 周红星 袁祥生 CHENG Xiaohui;ZHOU Hongxing;YUAN Xiangsheng(The Second Department of Orthopedics,the 989th Hospital of the People’s Liberation Army Joint Logistic Support Force,Pingdingshan 467000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院平顶山医疗区骨二科,河南平顶山467000

出　　处：《河南医学研究》2023年第24期4477-4480,共4页Henan Medical Research

摘　　要：目的比较组配式假体置换与3D打印钽块植入治疗胫骨近端Ⅲ级原发性骨巨细胞瘤的临床效果。方法回顾性选取2016年5月至2019年5月解放军第九八九医院平顶山医疗区收治的32例胫骨近端Ⅲ级原发性骨巨细胞瘤患者,根据手术方式分为两组,观察组(16例)接受膝关节组配式假体重建,对照组(16例)接受3D打印钽块植入治疗,随访至少3 a,采用美国特种外科医院膝关节评分(HSS)、视觉模拟评分(VAS)、膝关节活动度评价膝关节功能;评估假体位置以及肿瘤复发情况。结果两组患者随访3个月~3 a,平均(28.72±2.36)个月。试验组无复发病例,对照组有3例患者术后2 a复发,对照组术后2 a复发率高于试验组(P>0.05)。术后两组VAS随时间呈下降趋势,HSS评分和膝关节活动度随时间呈上升趋势(P<0.05)。末次随访X线显示假体和植入物位置良好。结论瘤段切除加组配式假体置换治疗胫骨近端Ⅲ级原发性骨巨细胞瘤可重建良好的膝关节功能,且复发率较低。Objective To compare the clinical effect of combined prosthesis replacement and 3-dimensional printed tantalum block implantation in the treatment of gradeⅢprimary giant cell tumors of the proximal tibia.Methods A retrospective study was conducted on 32 patients with gradeⅢprimary giant cell tumor of the proximal tibia admitted to the 989th Hospital of the People’s Liberation Army Joint Logistic Support Force from May 2016 to May 2019.They were divided into two groups according to the surgey method.The observation group(16 cases)accepted combination prosthesis reconstruction of knee joint function,while the control group accepted 3-dimensional printed tantalum block implantation.After at least 3 years of follow-up,hospital for special surgery knee score(HSS),visual analogue scale(VAS)and knee joint range of motion was used to evaluate knee joint function.The position of the prosthesis and the recurrence of the tumor was evaluated.Results The follow-up time of two groups was 3 months to 3 years,with an average of(28.72±2.36)months.There was no recurrent cases in the observation group,while there were 3 patients in the control group who experienced recurrence 2 years after surgery,the recurrence rate in the control group was higher than that in the observation group(P>0.05).After surgery,VAS scores of the two groups showed a downward trend over time,while HSS scores and knee joint activity showed an upward trend over time(P<0.05).The X-ray at the last follow-up showed that the prosthesis and implant were in good position.Conclusion Tumor segment resection and combined prosthesis replacement can reconstruct good knee function of gradeⅢprimary giant cell tumors of the proximal tibia,and the recurrence rate was lower.

关 键 词：骨巨细胞瘤 瘤段切除 组配式膝关节假体 3D打印 膝关节功能重建 

分 类 号：R738.1[医药卫生—肿瘤]