异体半关节移植术

ALLOGRAFT REPLACEMENT OF SEMI-ARTHROPLASTY

近关节端骨质良性肿瘤和低度恶性肿瘤,可以局部截除,行异体半关节移植术。我院自1977年始,共移植14例。12例成功,2例因感染失败。 异体关节取材于健康的猝死者。用深低温(-170C)快速冰冻保存。使用期为3周至6个月。这种方法可以保持骨细胞的生物活力,并可使抗原破坏。因此异体关节移植后无免疫反应,移植骨全部成活。 其中11例经过1年半至5年随访。其中位于胫骨上端的7例巨细胞瘤患者均有90°左右运动功能。2例肉瘸患者经过1年半及3年以上随访肿瘤未复发。全部病例患肢均可负重及行走。

Benign or low-grade malignant tumor of bones neighbouring a joint can be treated by segmental resection and the use of an allograft for reconstruction. Fourteen patients have been treated in this way since 1977, with success in 12 cases and failure in 2 because of infection.Allograft was obtained from fresh cadaver and stored in deep-frozen state (-170C). Within 3 weeks to 6 months, the biological vigor of the bone tissue could be retained and its antigenicity destroyed, so that no immunological reaction took place after replacing the joint and the allograft survived.Eleven patients have been followed up from one and one-half years to five years In the 7 cases with giant-cell tumor at the proximal end of tibia, their range of movement has been attained around 90 degrees. Of the two patients with os-teogenic sarcoma, one has been followed up for one and a half years, and the other for three years. There appears no evidence of local recurrence or distant metastasis in both. The affected limbs are all capable of weight-bearing and locoma-tion.