可旋转铰链式膝关节在骨肿瘤保肢术中的应用

Application of rotation knee system in the treatment of bone tumor

[目的]探讨膝关节肿瘤的保肢治疗以及可旋转铰链式膝关节在保肢手术中的适应证及手术方法.[方法]自1997年10月～2004年10月作者采用可旋转铰链式膝关节置换膝关节肿瘤病人11例11膝.所有病例均进行了随访,随访时间最长7 a,最短6个月,采用HSS(hospital for special surgery)评分标准对手术疗效进行评价.[结果]所有患者术后评分均为优.11例假体无1例松动,4例恶性骨肿瘤2例软骨肉瘤随访已过3 a,现生存良好.1例股骨骨肉瘤于术后1 a出现股骨近端部位跳跃转移,后截肢.1例骨肉瘤于1 a 8个月出现肺转移,1例骨巨细胞瘤于术后1 a出现肺部转移,现仍存活,关节功能良好.[结论]可旋转铰链式膝关节置换膝关节肿瘤病人是一种有效的保肢方法,但选择适应证应慎重.

[ Objective] To study the results of application of rotation knee system in the treatment of bone tumor treatment and the operative indication and method of total knee replacement. [ Method] Eleven knees of 11 patients with bone tumors near the knee underwent total knee replacement by using rotation knee system from Oct. 1997 to Oct. 2004. The patients were followed up for 6 months to 7 years. The HSS knee rating score system was used to evaluate the clinical results. [ Result] Excellent results were received in all cases. Local relapse oceurred in one case after operation one year later, the amputation of the replaced knee joint was performed; lung metastasis occurred in 2 cases; the 2 cases survived with satisfactory function. [ Conclusion] The knee replacement system is an effective method to treat bone tumors near the knee, but the operative indication should be carefully selected.