肿瘤型假体置换治疗近关节部位骨巨细胞瘤37例临床分析

Tumor-type prosthesis replacement for treatment of giant cell tumors of bone near the joints

目的 评价肿瘤型假体置换治疗近关节部位骨巨细胞瘤（GCT）的疗效.方法 1998年1月至2008年1月收治近关节部位GCT 37例.股骨远端23例,胫骨近端10例,肱骨近端3例,股骨近端1例.Companacci分级,Ⅱ级9例,Ⅲ级28例.所有患者行瘤段切除、肿瘤型假体置换治疗.术后采用MsTS 93评分系统进行功能评价.结果 随访2～9年,1例术后2年3个月肿瘤局部复发,1例接受截肢手术.1例假体感染,2例假体松动.术后3年MSTS 93评分系统评分平均为（22.49±5.16）分.肢体功能评估优良率为89.2%（33/37）.结论 肿瘤型假体置换是近关节部位GCT减少复发、重建功能的一种有效方法.

Objective To assess the clinical effect of tumor-type prosthesis replacement for treatment of giant cell tumors of bone near the joints. Methods Thirty-seven patients with giant cell tumors of bone near the joints from January 1998 to January 2008 were reviewed. 18 were males and 19 were females. The ages ranged from 19 to 64 and the median age was 32 years old. The anatomic site of the lesions spreaded at distal femur（23 cases） , proximal tibia（10 cases）,proximal humerus（3 cases） and proximal femur（1 case）. According to Companacci＇s staging system： 9 patients were classified as grade II and 28 as grade Ⅲ. All patients had been treated with block excision and reconstruction with prosthesis. The functional outcomes were evaluated by MSTS 93 score. Results According to the follow-up for 2 -9 years,1 patient （4. 3% ） had local recurrence and underwent amputation of the diseased limb. As for the complications, periprosthesis infection occurred in 1 patient, prosthesis loosening in 2 patients. The average MSTS 93 score was 22. 49 ±5. 16 in 3 years after surgery. The evaluated functional result revealed excellent or good performance in 89. 2% of the patients. Conclusions Tumor-type prosthesis replacement is an effective procedure to reduce the local recurrence,and to restore joint function.