【摘要】 目的 :探讨扩大刮除骨水泥填充联合内固定治疗临膝关节CampanacciⅢ级骨巨细胞瘤的疗效。方法:自2006年1月至2016年12月,采用扩大刮除骨水泥填充联合内固定治疗21例膝关节CampanacciⅢ级骨巨细胞瘤患者,其中男11例,女10例;年龄21～61(35.24±10.56)岁;病程1.5～24.0(8.1±4.4)个月。其中股骨远端8例,胫骨近端13例;均为原发性肿瘤。比较手术前后MSTS评分以评价患者下肢功能,拍摄X线片观察病灶愈合情况及不良反应。结果:术后患者伤口均甲级愈合,无伤口感染及内固定失效等并发症发生。全部病例获得随访,时间8～56(29.62±9.48)个月。末次随访时MSTS评分26.71±2.35,高于术前15.24±1.14(t=20.160,P=0.000)。复查X线片示所有患者内固定位置良好,无松动及软骨下骨骨折。术后复发3例,均采用肿瘤假体置换。结论:扩大刮除骨水泥填充联合钢板内固定术是治疗临膝关节CampanacciⅢ级骨巨细胞瘤的有效方法,可有效地保留膝关节功能,降低肿瘤复发率。更多还原

【Abstract】 Objective:To evaluate clinical effects of expanded curettage and bone cement filling combined with internal fixation in treating Campanacci Ⅲ giant cell tumor of knee joint. Methods:From January 2006 to December 2016,21 patients with Campanacci Ⅲ giant cell tumor of knee joint were treated by expanded curettage and bone cement filling combined with internal fixation,including 11 males and 10 females with an average age of(35.24±10.56) years old(ranged from 21 to 61 years old). The courses of disease ranged from 1.5 to 24.0 months with an average of(8.1±4.4) months. Among them,8 patients were distal femur and 13 patients were proximal tibia. All patients were primary tumors. Musculoskeletal Tumor Society(MSTS) scores were used to evaluate lower limb function before and after operation. X-ray was used to observe healing of lesions and the occurrence of adverse reactions. Results:All incisions were healed at grade A without complications such as infection and internal fixation failure. All patients were followed up from 8 to 56 months with an average of(29.62±9.48) months.MSTS score at the latest follow-up 26.71±2.35 was higher than that of before operation 15.24±1.14,and had statistical significance(t=20.160,P=0.000). The results of X-ray at final following up showed internal fixation was well,and no loosening and fracture of subchondral bone. Three patients recurred giant cell tumor and replaced with tumor prosthesis. Conclusion:Expanded curettage and bone cement filling with internal fixation for the treatment of Campanacci Ⅲ giant cell tumor of knee joint could effectively retain limb function and reduce tumor recurrence rate.更多还原