绞链式全膝关节置换手术治疗股骨下端恶性骨肿瘤的临床优势评估

Evaluation of the clinical advantages of hinged total knee arthroplasty in the treatment of distal femur malignant bone tumor

目的评估绞链式全膝关节置换手术治疗股骨下端恶性骨肿瘤的临床优势。方法回顾性分析新疆维吾尔自治区人民医院北院2012年1月至2014年1月间治疗的82例股骨下端恶性骨肿瘤患者的临床资料,采用绞链式全膝关节置换手术治疗的42例作为观察组,采用非绞链式全膝关节置换手术治疗的40例作为对照组,比较两组患者的手术疗效、膝关节功能及并发症情况。结果观察组患者的总有效率为95.2%,显著高于对照组的72.5%,差异有统计学意义(P<0.05);术前两组患者的医院膝关节功能评分(HSS评分)差异均无统计学意义(均P>0.05),术后6个月两组患者的HSS评分较术前均显著改善,并且观察组患者的HSS评分优于对照组,差异有统计学意义(P<0.05);观察组并发症的发生率为4.8%,对照组为12.5%,差异有统计学意义(P>0.05)。结论绞链式全膝关节置换手术治疗股骨下端恶性骨肿瘤临床效果满意,能明显改善患者的关节功能,预后良好,可以作为优选的手术方案。

Objective To evaluate the clinical advantages of hinged total knee arthroplasty in the treatment of distal femur malignant bone tumor. Methods From January 2012 to January 2014,the clinical data of 82 patients with distal femur malignant bone tumor were analyzed retrospectively. 42 cases were treated with hinged total knee arthroplasty as the observation group,while 40 cases were treated with non-hinged total knee arthroplasty as the control group. The surgical effect,knee function and complications of two groups were compared. Results The total efficiency rate of observation group was 95. 2%,significantly higher than 72. 5% of the control group,with significant difference（ P〈0. 05）; The hospital for special surgery knee（ HSS） scores of two groups patients before operation had no significant differences（ P〉0. 05）; The HSS scores of 6 months after operation in two groups were significantly improved than before operation,and HSS score in the observation group was better than that in the control group,with significant difference（ P〈0. 05）; The complication rate of observation group was 4. 8%,while the control group was12. 5%,and there was no significant difference between two groups（ P〈0. 05）. Conclusions Hinged total knee arthroplasty in the treatment of distal femur malignant bone tumor has clinical efficacy,can significantly improve the joint function,and the prognosis is good,so it can be used as the preferred surgical options.