【摘要】 目的评价定制型人工关节在股骨远端肿瘤保肢术中的作用。方法回顾分析我院接受定制型人工关节置换进行保肢治疗的股骨远端肿瘤患者38例,其中良性肿瘤9例,分别是骨巨细胞瘤7例(复发性骨巨细胞瘤5例,骨折2例),骨巨细胞瘤合并动脉瘤样骨囊肿1例,骨母细胞瘤1例;恶性肿瘤29例,分别是成骨性骨肉瘤16例,转移性肿瘤6例(骨折2例),软骨肉瘤2例,恶性纤维组织细胞瘤3例(骨折1例),纤维肉瘤1例,局灶性骨髓瘤1例。所有患者均使用国产定制型人工膝关节,铰链式17例,后稳定型21例。结果9例良性肿瘤患者1例失访,1例死于其他不相关疾病,其余7例病人随访时膝关节功能按Ennek ing制定的标准进行评定,优5例,良1例,差1例,保肢成功率为100%;29例恶性骨肿瘤患者,骨肉瘤患者失访7例,2例患者术后局部复发,行截肢术;其余20例患者生存期间膝关节功能优10例,良4例,差6例。7例效果评价差的病人为有6例为铰链式膝关节假体。结论定制型人工膝关节置换是一种较好的股骨远端肿瘤保肢方法。更多还原

【Abstract】 Objective To evaluate the role of the custom knee prosthesis in the limb salvage procedure of distal femur tumors.Methods Thirty-eight patients of distal femur tumors(benign tumor,nine patients;malignant tumors,twenty-nine patients)treated with custom knee prothesis were retrospectively reviewed.The benign tumors included seven cases of giant cell tumors(five cases of recurred giant cell tumors,two with pathologic fracture).One case of giant cell tumor with aneurismal cyst,one of osteoblastoma.The malignant tumors included osteogenic osteosarcoma(sixteen patients),metastasis tumor(six patients,two with pathologic fractures),chondrosarcoma(two patients),malignant fibrous histiocytoma(three patients,one with pathologic fracture),fibrosarcoma(one patient),and solitary myeloma(one patient).all patients received limb savage procedure with custom knee prosthesis including sevnteen cases of hinge joint and twenty-one cases of posterior stability joints.Results One of nine patients with benign tumors was lost for followed-up,one patient died of unrelated disease,the remained patients have excellent function in five patients,good function in one case,and one poor according to the Enneking evaluating system.the limb salvage rate was 100%.Seven patients were lost for followed-up in twenty-nine of malignant tumors,two patient with malignant fibrous histiocytoma received amputation due to local recurrence nine months postoperatively.Ten patients had excellent function,four good and six poor among the followed-up patients.The type of prosthesis in six of all patients with poor function was hinge.Conclusion The custom knee prosthesis replacement was one of the optional methods of limb salvge procedures for distal femur tumors.更多还原