Primary malignant giant cell tumor of bone is clinically rare,lack of specificity,and often misdiagnosed.Currently,related literature about this tumor remains scarce.One case of primary malignant giant cell tumor of b...Primary malignant giant cell tumor of bone is clinically rare,lack of specificity,and often misdiagnosed.Currently,related literature about this tumor remains scarce.One case of primary malignant giant cell tumor of bone was diagnosed and treated in our hospital,and the treatment effect was satisfactory.There was no recurrence or metastasis in 2 years of followup.The report is as follows.展开更多
Objectives:3D design,which is widely used in orthopedics,can be applied for precise distal femoral megaprosthetic revision.This research aimed to present and evaluate the design,perioperative management,and midterm cl...Objectives:3D design,which is widely used in orthopedics,can be applied for precise distal femoral megaprosthetic revision.This research aimed to present and evaluate the design,perioperative management,and midterm clinical outcomes of a 3D design custom-made uncemented prosthetic stem.Methods:Between January 2014 and January 2016,seven patients received 3D design custom-made uncemented prosthetic stem revision at our institution.Clinical records and radiographs were evaluated retrospectively.Results:There were no hardware-related complications during the follow-up(average 24.3 months;range 24–48 months).The average Musculoskeletal Tumor Society(MSTS)score at the last follow-up after revision(27.7 points,range 25–28 points)was significantly higher than that before(16.0 points,range 13–18 points).In addition,the range of motion(ROM)of the affected knee,and the scores of pain,function,emotional acceptance,support,walking and gait all improved significantly.The antecurvature radian of the revision stem averaged at 3.6°.Of the seven patients,three received femoral stem revision and four received revision of the femoral stem and the femoral component;three of them used longer prostheses than the others.There were no significant differences in function between these two groups at the last follow-up after revision.Conclusion:The 3D design custom-made prosthesis is a typical precision medicine technology in oncologic orthopedics.Characterized by its individually and precisely designed uncemented stem,it offers an alternative option for distal femoral cemented prosthesis revision.Besides the 3D design itself,the perioperative management,especially the techniques for stem implantation,and long-term follow-up are also crucial.展开更多
目的探索3D打印股骨近端弧形柄仿生假体的设计要点,评估将其应用于重建股骨中上段超极限骨缺损的手术要点和中期临床疗效。方法2015年10月—2021年1月,17例患者接受了3D打印股骨干弧形柄仿生假体重建。男11例,女6例;年龄10~76岁,平均30....目的探索3D打印股骨近端弧形柄仿生假体的设计要点,评估将其应用于重建股骨中上段超极限骨缺损的手术要点和中期临床疗效。方法2015年10月—2021年1月,17例患者接受了3D打印股骨干弧形柄仿生假体重建。男11例,女6例;年龄10~76岁,平均30.1岁。骨肉瘤9例,尤文肉瘤4例,软骨肉瘤2例,脂肪肉瘤1例,肌纤维母细胞瘤1例。病程5~14个月,平均9.5个月。Enneking分期:ⅡB期16例,ⅢB期1例。根据X线片测量术前股骨头中心到人体正中线和髋臼顶点的距离,术后即刻及末次随访时弧形柄尖端到人体正中线和髋臼顶点的距离,以及术前、术后即刻和末次随访时的颈干角。通过X线片、CT和断层融合成像技术(Tomosynthesis-Shimadzu metal artefact reduction technology,T-SMART)评估骨-假体界面的骨整合状况及假体表面骨长入情况。随访患者生存状态、有无局部复发或远处转移,术后并发症发生情况。手术前后通过肌肉骨骼肿瘤学会(MSTS)评分评价下肢功能恢复情况,疼痛视觉模拟评分(VAS)评价疼痛缓解情况。结果患者股骨切除长度为(163.1±57.5)mm,剩余股骨近端长度为(69.6±9.3)mm,股骨切除长度/股骨总长度百分比为38.7%±14.6%。17例患者均获随访,随访时间25~86个月,平均58.1个月。随访期间1例患者于术后46个月死于肺转移,余16例患者无瘤生存。均未发生假体周围感染、切口延迟愈合、假体无菌性松动、假体断裂、假体周围骨折等并发症。X线片和T-SMART评估未发现植入假体柄周围微动磨损,也无明显放射性透亮带,并且在所有柄中都发现了骨-假体界面上骨向内生长的射线学迹象。术后即刻及末次随访时弧形柄尖端到人体正中线和髋臼顶点的距离分别与术前股骨头中心到人体正中线和髋臼顶点的距离比较,差异无统计学意义(P>0.05);术后即刻和末次随访间上述指标比较差异亦无统计学意义(P>0.05)。手术前后各时间点颈干角比较差异均无统计学意义(P>0.05)。末次随访时患者MSTS评分为(26.1±1.2)分,VAS评分为(0.1±0.5)分,均较术前[分别为(19.4±2.1)分和(5.7±1.0)分]显著改善(t=14.735,P<0.001;t=21.301,P<0.001)。末次随访时,患者均无需借助拐杖或其他助行器行走。结论3D打印股骨近端弧形柄仿生假体是股骨中上段恶性肿瘤切除术后超极限骨缺损重建的有效方法,术中操作可靠,术后下肢功能恢复满意,并发症发生率低。展开更多
基金on the treatment ofknee osteoarthritis by Kangjian5s three-dimensional model(2020XZ003)。
文摘Primary malignant giant cell tumor of bone is clinically rare,lack of specificity,and often misdiagnosed.Currently,related literature about this tumor remains scarce.One case of primary malignant giant cell tumor of bone was diagnosed and treated in our hospital,and the treatment effect was satisfactory.There was no recurrence or metastasis in 2 years of followup.The report is as follows.
基金supported,in part,by the National Natural Science Foundation of China(81702664).
文摘Objectives:3D design,which is widely used in orthopedics,can be applied for precise distal femoral megaprosthetic revision.This research aimed to present and evaluate the design,perioperative management,and midterm clinical outcomes of a 3D design custom-made uncemented prosthetic stem.Methods:Between January 2014 and January 2016,seven patients received 3D design custom-made uncemented prosthetic stem revision at our institution.Clinical records and radiographs were evaluated retrospectively.Results:There were no hardware-related complications during the follow-up(average 24.3 months;range 24–48 months).The average Musculoskeletal Tumor Society(MSTS)score at the last follow-up after revision(27.7 points,range 25–28 points)was significantly higher than that before(16.0 points,range 13–18 points).In addition,the range of motion(ROM)of the affected knee,and the scores of pain,function,emotional acceptance,support,walking and gait all improved significantly.The antecurvature radian of the revision stem averaged at 3.6°.Of the seven patients,three received femoral stem revision and four received revision of the femoral stem and the femoral component;three of them used longer prostheses than the others.There were no significant differences in function between these two groups at the last follow-up after revision.Conclusion:The 3D design custom-made prosthesis is a typical precision medicine technology in oncologic orthopedics.Characterized by its individually and precisely designed uncemented stem,it offers an alternative option for distal femoral cemented prosthesis revision.Besides the 3D design itself,the perioperative management,especially the techniques for stem implantation,and long-term follow-up are also crucial.
文摘目的探索3D打印股骨近端弧形柄仿生假体的设计要点,评估将其应用于重建股骨中上段超极限骨缺损的手术要点和中期临床疗效。方法2015年10月—2021年1月,17例患者接受了3D打印股骨干弧形柄仿生假体重建。男11例,女6例;年龄10~76岁,平均30.1岁。骨肉瘤9例,尤文肉瘤4例,软骨肉瘤2例,脂肪肉瘤1例,肌纤维母细胞瘤1例。病程5~14个月,平均9.5个月。Enneking分期:ⅡB期16例,ⅢB期1例。根据X线片测量术前股骨头中心到人体正中线和髋臼顶点的距离,术后即刻及末次随访时弧形柄尖端到人体正中线和髋臼顶点的距离,以及术前、术后即刻和末次随访时的颈干角。通过X线片、CT和断层融合成像技术(Tomosynthesis-Shimadzu metal artefact reduction technology,T-SMART)评估骨-假体界面的骨整合状况及假体表面骨长入情况。随访患者生存状态、有无局部复发或远处转移,术后并发症发生情况。手术前后通过肌肉骨骼肿瘤学会(MSTS)评分评价下肢功能恢复情况,疼痛视觉模拟评分(VAS)评价疼痛缓解情况。结果患者股骨切除长度为(163.1±57.5)mm,剩余股骨近端长度为(69.6±9.3)mm,股骨切除长度/股骨总长度百分比为38.7%±14.6%。17例患者均获随访,随访时间25~86个月,平均58.1个月。随访期间1例患者于术后46个月死于肺转移,余16例患者无瘤生存。均未发生假体周围感染、切口延迟愈合、假体无菌性松动、假体断裂、假体周围骨折等并发症。X线片和T-SMART评估未发现植入假体柄周围微动磨损,也无明显放射性透亮带,并且在所有柄中都发现了骨-假体界面上骨向内生长的射线学迹象。术后即刻及末次随访时弧形柄尖端到人体正中线和髋臼顶点的距离分别与术前股骨头中心到人体正中线和髋臼顶点的距离比较,差异无统计学意义(P>0.05);术后即刻和末次随访间上述指标比较差异亦无统计学意义(P>0.05)。手术前后各时间点颈干角比较差异均无统计学意义(P>0.05)。末次随访时患者MSTS评分为(26.1±1.2)分,VAS评分为(0.1±0.5)分,均较术前[分别为(19.4±2.1)分和(5.7±1.0)分]显著改善(t=14.735,P<0.001;t=21.301,P<0.001)。末次随访时,患者均无需借助拐杖或其他助行器行走。结论3D打印股骨近端弧形柄仿生假体是股骨中上段恶性肿瘤切除术后超极限骨缺损重建的有效方法,术中操作可靠,术后下肢功能恢复满意,并发症发生率低。
