摘要
目的:回顾性总结膝关节恶性骨肿瘤不同保肢手术方法的经验,比较各自的优缺点。方法:自1990年1月至2002年3月进行保肢手术的膝关节恶性骨肿瘤63例,其中瘤段灭活再植28例、异体骨移植22例、人工假体置换13例,比较三种保肢手术后的局部复发率、并发症发生以及膝关节功能。结果:瘤段灭活再植的局部复发率为21.％,异体骨移植为18.2％,假体置换为15.4％,假体置换的并发症明显小于其他两组。结论:假体置换具有并发症少,恢复快,功能好的优点。但对于青少年膝关节恶性骨肿瘤患者,尤其是骨骺没有愈合者,癌段灭活再植及异体骨移植仍然是简单有效的方法。
To report the experience of limb salvage with different methods for
malignant tumors of the knee and discuss their advantages and disadvantages. Methods From January 1990 to March 2002, 63 patients with malignant tumors of the knee underwent limb salvage surgery. After en bloc resection, 28 cases were reconstructed with devitalized original tumor-bearing bone, 22 cases with allograft, and 13 cases with tumor endoprostheses. The local recurrences, complications and knee function of three different surgical methods were compared. Results Although the local recurrences of the three groups were similar (21.4% for the devitalized bone, 18. 2% for the allograft and 15. 4% for tumor endoprotheses), tumor endoprotheses showed less complications and better knee function. Conclusions The present study shows that limb salvage with endoprothesis has less complication and better knee function, however, reconstruction with devitalized tumor-bearing bone and allograft are still simple and useful tool for skeletal immature young patients.
