人工假体在膝关节周围骨肿瘤保肢治疗中的应用  

Application of prosthesis replacement in limb salvage treatment of tumors at the knee

作　　者：叶澄宇[1] 杨胜武[1] 滕红林[1] 陈雷[1] 林垂聪[1] 金广健[1] 

机构地区：[1]温州医学院附属第一医院骨科,浙江温州325000

出　　处：《中国骨伤》2004年第3期151-153,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨对膝关节周围骨肿瘤切除后 ,采用人工全膝关节置换达到保肢的疗效。方法 :1996 - 2 0 0 0年共收治骨肿瘤患者 11例 ,年龄 18～ 5 5岁 ,其中恶性骨巨细胞瘤 6例 ,骨肉瘤 2例 ,软骨肉瘤 2例 ,纤维肉瘤 1例。股骨下端病变 7例 ,胫骨上端病变 4例。肢体功能重建方法为特制的人工全膝关节置换术。结果 :本组 11例经 3～ 6年随访 ,8例无瘤存活 ,3例带瘤存活。术后肢体功能按Enneking评分系统评分 ,平均为 2 1 5分 ,总优良率 72 7% ,其中股骨远端肿瘤术后平均为 2 2 3分 ,胫骨近端肿瘤术后平均为 2 0 0分。结论 :采用特制的人工全膝关节置换术 ,能有效治疗膝关节周围低度恶性或恶性骨肿瘤 ,达到良好保肢效果。Objective:To investigate the clinical outcome of application of prosthetic knee replacement in limb salvage treatment of primary malignant tumor at the distal part of the femur and proximal part of the tibia.Methods:Data of 11 consecutive patients with tumors of the knee treated with prosthetic knee replacement from 1996 to 2000 were reviewed.The average age of these 11 patients was 33 8 years(range 18 to 55 years).There were 7 distal femoral and 4 proximal tibial replacements.The diagnoses of 11 patients were giant cell tumor in 6 cases,osteosarcoma in 2,chondrosarcoma in 2 and fibrosarcoma in 1.The reconstruction of limb function was total knee replacement with individualized prosthesis.Results:The duration of follow up ranged from 3 to 6 years.At the time of the last follow up,8 patients were disease free,3 were alive with metastatic disease.None of them developed local recurrences.According to Enneking score system,the mean functional score was 21 5 points and the excellent and good rate was 72 7%.Conclusion:Application of prosthetic knee replacement in limb salvage treatment of tumor at the knee is effective,especially for those with massive bone destruction.

关 键 词：人工假体 膝关节周围骨肿瘤 保肢术 手术治疗 人工全膝关节置换术 

分 类 号：R738.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]