可旋转稳定型假体与单纯铰链型假体治疗胫骨近端恶性骨肿瘤的临床对照研究

Comparison of the Spin Stabilized Prosthesis and Simple Hinge Prosthesis in Treatment of Proximal Tibia Malignant Bone Tumor

目的对比可旋转稳定型假体与单纯铰链型假体治疗胫骨近端恶性骨肿瘤的疗效。方法选取了80例胫骨近端恶性骨肿瘤患者,按随机数字表法分为2组,对照组(39例)给予单纯铰链型假体治疗,观察组(41例)给予可旋转稳定型假体治疗,通过观察2组术后膝关节功能、膝关节伸屈度、术前术后KPS评分及随访期间复发率和并发症情况,比较可旋转稳定型假体与单纯铰链型假体治疗胫骨近端恶性骨肿瘤的疗效。结果术后6个月,观察组肢体功能总的优良率90.2%,对照组肢体功能总的优良率84.6%,2组优良率无统计学差异。膝关节屈伸度方面,2组伸直度均为0°;屈曲度方面,观察组屈曲度较大(P<0.05)。术前2组KPS评分相比,无统计学差异(P>0.05);术后3个月、6个月,2组患者KPS均明显提高(P<0.05),且观察组KPS分值更高(P<0.05)。随访期间,2组复发率无统计学差异(P>0.05)。并发症方面,共发生2例并发症。结论可旋转稳定型假体与单纯铰链型假体对胫骨近端恶性骨肿瘤均具有较好的疗效,其中,可旋转稳定型假体屈伸范围较大,安装后能明显提高患者生活质量,不易出现假体松动等并发症。

Objective To compare the spin stabilized prosthesis and simple hinge prosthesis in the treatment of proximal tibia malignant bone tumor. Methods 80 patients with proximal tibia malignant bone tumor were selected, they were divided into 2 groups randomly. The control group （39 cases） was given simple hinge prosthesis. The observation group （41 cases） was given spin stabilized prosthesis. The efficacy of spin stabilized prosthesis and simple hinge prosthesis in the treatment of proximal tibia malignant bone tumor was evaluated by the postoperative knee function, knee flexion, preoperative and postoperative KPS score, re- currence rate and complications during follow-up. Results After 6 months surgery,The excellent rate was 90.2% in the observa- tion group and 84.6% in the control group. There were no statistical significance in the excellent rate between 2 groups （ P 〉 0.05 ）. The straight degree of the 2 groups were 0, the flexion was wider in the observation group （ P 〈 0.05 ）. There were no sta- tistical significance on KPS scores between the 2 groups（ P 〉 0.05 ）. After 3 months and 6 months surgery, the KPS scores were increased in the 2 groups, and the observation group was higher（ P 〈 0.05 ）. During follow-up, there were no statistical significance in recurrence rate between two groups. There were 2 complications occurred during follow-up. Conclusion The spin stabilized prosthesis and simple hinge prosthesis have a good curative effect on proximal tibia malignant bone tumor. The flexion range is wi- der by the spin stabilized prosthesis. The quality of life can be improved after installation without loosening. It is worthy of clinical use.