Renard A J, Veth R P, Schreuder H W, van Loon C J, Koops H S, van Horn J R
Department of Orthopaedics, Nijmegen University Hospital, Nijmegen, The Netherlands.
J Surg Oncol. 2000 Apr;73(4):198-205. doi: 10.1002/(sici)1096-9098(200004)73:4<198::aid-jso3>3.0.co;2-x.
The functional results and the complications after several limb-saving and ablative treatments because of lower extremity bone sarcoma were evaluated.
Seventy-seven surviving patients were evaluated according to the MSTS (American Musculoskeletal Tumor Society) functional rating system. Fifty-two patients had limb-saving and 25 had ablative therapy. Median follow-up was 97 months in the limb-saving group and 112 months in the ablative group.
Functional results in the limb-saving group were significantly better than in the ablative group (P = 0.0001). Functional results in patients with tumors about the knee joint were significantly better (P = 0.0064) after limb-saving surgery (i.e., endoprosthesis, knee arthrodesis, or rotationplasty) compared to functional results after ablative surgery (i.e., hip or knee disarticulation or above-the-knee amputation). Complications were 3 times more common after limb-salvage procedures and 4 times more common after endoprosthetic reconstructions compared to after ablative procedures. Complications after limb-saving therapy were fewest in tumors about the knee joint. In 3/28 patients, the endoprosthetic reconstruction had to be converted to an amputation.
Functional results were significantly better after limb-saving compared to after ablative therapy. Complications, however, were more common after limb-saving therapy.
评估因下肢骨肉瘤接受多种保肢及截肢治疗后的功能结果与并发症情况。
依据MSTS（美国肌肉骨骼肿瘤学会）功能评分系统对77例存活患者进行评估。52例患者接受了保肢治疗，25例接受了截肢治疗。保肢组的中位随访时间为97个月，截肢组为112个月。
保肢组的功能结果显著优于截肢组（P = 0.0001）。与截肢手术（即髋关节或膝关节离断术或膝上截肢术）后的功能结果相比，膝关节周围肿瘤患者接受保肢手术（即假体植入、膝关节融合术或旋转成形术）后的功能结果显著更好（P = 0.0064）。与截肢手术相比，保肢手术的并发症发生率高出3倍，假体植入重建术后的并发症发生率高出4倍。膝关节周围肿瘤保肢治疗后的并发症最少。28例患者中有3例的假体植入重建不得不改为截肢。
与截肢治疗相比，保肢治疗后的功能结果显著更好。然而，保肢治疗后的并发症更常见。
