旋转铰链型人工膝关节置换在胫骨近端侵袭性骨肿瘤治疗中的应用

Knee replacement for the treatment of malignant tumor of the proximal tibia and early follow-up

目的 探讨应用旋转铰链型人工膝关节置换治疗胫骨近端原发侵袭性骨肿瘤的临床效果。方法 胫骨近端原发侵袭性骨肿瘤患者 30例 ,男 17例 ,女 13例 ,平均年龄 2 8 5岁 ;其中骨肉瘤2 0例 ,软骨肉瘤 3例 ,Ⅱ～Ⅲ级骨巨细胞瘤 7例。对胫骨近端肿瘤进行广泛切除或根治性切除后 ,采用旋转铰链型人工膝关节置换重建 ;对骨肉瘤同时采用新辅助化疗治疗。结果 30例患者平均随访4 2年。其中 2 2例患者无局部复发或远处转移迹象 ,8例出现复发 ;术后 4年MSTS功能评分提示70 %的患者的各项评估在 3分以上。

Objective To discuss the clinical effects of using rotating hinge prosthesis in treating primary malignant tumor of the proximal tibia. Methods After the malignant tumor of the proximal tibia was extensively resected or radically resected,rotating hinge prosthesis replacement was performed for reconstruction,while neoadjuvant chemotherapy was used in treating the osteosarcoma. Results The average follow-up period was 4.2 years.There was no local recurrence and metastasis in 22 patients,though there was recurrence in 8 patients.The MSTS functional scores of all different items 4 years after the operations were above 3,which showed the clinical results were satisfactory. Conclusions It is an efficacious method for the treatment of malignant tumor of the proximal tibia by using rotating hinge prosthesis.It has the advantage of early recovery of joint function.