人工假体置换重建膝关节周围骨肿瘤切除后骨缺损

目的探讨应用人工假体置换治疗膝关节周围原发性骨肿瘤的临床效果。方法应用肿瘤型人工假体置换治疗16例膝关节周围原发恶性与侵袭性骨肿瘤切除后骨缺损，其中骨肉瘤11例，骨巨细胞瘤3例，恶性纤维组织细胞瘤2例。股骨远端10例，胫骨近端6例。结果所有患者均获随访，随访时间10～83个月，平均35．5个月。局部复发3例，假体松动1例，无假体断裂。假体3年生存率87．5％，5年生存率83．2％。术后6～12个月后MSTS功能评分为16．0～28．0分，平均24．0分。结论对膝关节周围原发恶性与侵袭性骨肿瘤切除后骨缺损采用肿瘤型人工假体重建是有效的保肢方法。

Artificial prosthetic reconstruction after wide resection of primary bone tumor around the knee

Objective To investigate the clinical effects of the artificial prosthetic reconstruction after wide resection of primary bone tumor around the knee. Methods Tumor prosthesis was used to treat 16 patients with bone defects after the resection of primary and progressive malignant tumor around the knee. The tumor was osteosareoma （n=l 1）, giant bone cell tumor （n=3）, and malignant fibrous histiocytoma （n=2）. The lesion was at the distal femur （n=10）, and proximal tibia （n=6）. Results All patients were followed up for 10 to 83 months, with the average of 35.5 months. Local recurrence occurred in 3 patients, and prosthetic loosening occurred in 1 patient without fracatre of the prosthesis. The 3-year survival rate was 87.5% while the 5-year survival rate was 83.2%. Six to twelve months after surgery, the MSTS score was 16.0 to 28.0, 24.0 in average. Conclusions Tumor type prosthetic reconstruction for the bone defect after the resection of primary and progressive bone tumor around the knee is an effective way to save the limbs.