大段同种异体骨单髁置换术治疗膝关节周围骨肿瘤疗效观察

目的 探讨应用大段同种异体骨单髁置换术重建膝关节周围骨肿瘤切除后骨缺损的临床疗效。方法 回顾分析2007年1月—2014年1月采用大段同种异体骨单髁置换术治疗的9例膝关节周围骨肿瘤患者临床资料。其中男6例,女3例;年龄17~38岁,平均25.8岁。骨巨细胞瘤7例（其中1例为骨巨细胞瘤术后复发）,软骨黏液样纤维瘤2例。肿瘤位于股骨远端7例,胫骨近端2例;肿瘤部位均偏外侧。症状持续时间2~5个月,平均3.2个月。术前均行X线片和MRI检查,确定肿瘤范围6 cm×2 cm~9 cm×4 cm;CT检查排除肺部转移。术中置换的单髁同种异体骨长度为8.0~9.2 cm,平均8.6 cm。结果 患者术中出...

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Published in中国修复重建外科杂志 Vol. 31; no. 8; pp. 908 - 912
Main Author 黄俊琪 毕文志 韩纲 贾金鹏 许猛 王威
Format Journal Article
LanguageChinese
Published 2017
Subjects
保肢术
单髁置换术
同种异体骨
重建
骨肿瘤
Online AccessGet full text
ISSN1002-1892

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Summary:目的 探讨应用大段同种异体骨单髁置换术重建膝关节周围骨肿瘤切除后骨缺损的临床疗效。方法 回顾分析2007年1月—2014年1月采用大段同种异体骨单髁置换术治疗的9例膝关节周围骨肿瘤患者临床资料。其中男6例,女3例;年龄17~38岁,平均25.8岁。骨巨细胞瘤7例（其中1例为骨巨细胞瘤术后复发）,软骨黏液样纤维瘤2例。肿瘤位于股骨远端7例,胫骨近端2例;肿瘤部位均偏外侧。症状持续时间2~5个月,平均3.2个月。术前均行X线片和MRI检查,确定肿瘤范围6 cm×2 cm~9 cm×4 cm;CT检查排除肺部转移。术中置换的单髁同种异体骨长度为8.0~9.2 cm,平均8.6 cm。结果 患者术中出血量为400~550 mL,平均480 m L;术后输注红细胞0~3 U。1例患者拔除引流管后出现切口处持续渗液,3个月后愈合;其余患者术后2周切口均Ⅰ期愈合。9例患者均获随访,随访时间3~10年,平均6年。随访期间无术区感染发生,无同种异体骨愈合不良和断裂发生。术后1年膝关节活动度为90~110°,平均100°;肌肉骨骼肿瘤学会（MSTS）评分为24~29分,平均26分。X线片示同种异体骨内有密度减低区（骨溶解）6例;无关节面塌陷、骨裂或骨折发生;同种异体骨与宿主骨接触面之间均有骨痂形成,皮质骨连续性良好。结论 骨肿瘤切除后采用大段同种异体骨单髁置换重建,可提供良好支撑和功能,获得满意临床疗效。
Bibliography:HUANG Junqi, BI Wenzhi, HAN Gang, JIA Jinpeng, XU Meng, WANG Wei（Department of Orthopaedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China）
51-1372/R
Objective To analyze the effectiveness of unicompartment allografts replacement for reconstructing bone defect after bone tumor resection around knee. Methods Between January 2007 and January 2014, a total of 9 patients received unicompartment allografts replacement to treat bone tumor around the knee, including 6 males and 3 females, with an average age of 25.8 years （range, 17-38 years）. There were 7 patients with bone giant cell tumor （postoperative recurrence of bone giant cell tumor in 1 case） and 2 patients with chondromyxoid fibroma. The tumors were located at the distal femur in 7 cases and proximal tibia in 2 cases, and the tumors were almost at the lateral limbs. The symptom duration was 2-5 months （mean, 3.2 months）. The size of lesion ranged from 6 cm×2 cm to 9 cm×4 cm by X-ray film and MRI; and the metastasis was excluded by CT. The leng
ISSN:1002-1892