【摘要】 目的 :评估人工关节联合新辅助化疗在膝关节周围肿瘤保肢术中的临床效果和预后。方法 :1999年 1月～ 2 0 0 2年 12月对 5 6例膝关节周围肿瘤进行手术治疗 ,恶性肿瘤 5 0例 ,良性肿瘤 6例。 5 0例行人工关节置换。 6例截肢。 5 0例患恶性肿瘤病人均采用新辅助化疗方案化疗。结果 :6例病人失访 ,随访时间 10～ 44个月 (平均 2 2个月 ) ,49例病人生存。术后采用Enneking肢体肌肉骨骼肿瘤外科治疗重建术后功能评估标准进行评估。 4～ 5分 46人 ,3分 2人 ,1分 1人。结论 :人工关节置换 ,可明显提高膝关节周围肿瘤的保肢率及最大限度保留肢体的功能。更多还原

【Abstract】 Objective:To evaluate the clinical effectiveness and prognosis of limb salvage surgery combined with neoadjuvant chemotherapy for tumor around the knee Method:Between Jan 1999 and Dec 2001,56 patients had knee resection,for 50 malignant and 6 benign tumors,there were 38 osteosarcoma,4 synovial sarcoma,3 Ewing’s tumors,3 Metastatic tumors,6 Giant cell tumor of bone 50 prosthetic replacements and 6 amputations were performed There were 33 males and 23 females,aged 15～62 years(mean age 22) Thirty eight distal femur resections and 18 proximal tibial resections were performed The reconstruction was always achieved with a cemented,rotating hinge knee prosthesis,including revisions,there were total 51 prostheses in 50 patients In all tibial resections,the extensor mechamism had to be reconstructed Whole 50 patients who had malignant tumors received neoadjuvant chemotherapy Both preoperation and postoperation received three courses of chemotherapy respectively Result:Results and complications were retrospectively assessed With an average follow up of 22 months(10～44 months) Six patients were lost from follow up,49 patients were alive Two patients had lung metastasis and one had local recurrence,one patient died of chemotherapy related toxicity,infection one case,one among three aseptic loosing cases received reoperation Infection and recurrence resulted in amputation The patients were evaluated in regard to function with use of Enneking system,34 cases had excellent results,10 cases good,2 cases fair,one case poor An excellent or good results in 90% of the patients Conclusion:Prosthesis surgery may obviously improve the rate of limb salvage and reserve limb function in large extent更多还原