Guo Wei, Wang Xian-hai, Li Da-sen, Yang Yi
Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing 100044, China.
Zhonghua Wai Ke Za Zhi. 2007 Jun 15;45(12):825-8.
To summarize the effects and complications of osteosarcoma around knee treated by wide resection and replacement by the tumor-type prosthesis.
Between July 1997 and July 2004, 117 patients with osteosarcoma around the knee had been treated with wide resection and reconstruction with prosthesis. Alcohol-devitalized tumor bone prosthetic composite were used for reconstruction in 13 patients, and allograft prosthetic composite (APC) were used in 25 patients. All patients accepted 2 cycles of chemotherapy before the surgery.
The mean follow-up period was 3.5 years (1 - 8 years). Nine patients had failure of union at the graft-host junction. Fracture of the stem of the prosthesis occurred in 5 patients, late infection was found in 19 patients, and aseptic loosening occurred in 3 patients. Bone fracture occurred in 1 patient and prosthesis sinking occurred in 2 patients.
The tumor-type prosthetic reconstruction offers the best knee function after resection of the tumor around the knee, and recurrence rate can be accepted. However, the tumor-type prosthesis needs further improvement because of the high complication rate.
总结膝关节周围骨肉瘤行广泛切除并采用肿瘤型假体置换的疗效及并发症。
1997年7月至2004年7月,117例膝关节周围骨肉瘤患者接受了广泛切除及假体重建治疗。13例患者采用酒精灭活肿瘤骨假体复合物进行重建,25例患者采用同种异体骨-假体复合物(APC)进行重建。所有患者在手术前均接受2个周期的化疗。
平均随访时间为3.5年(1 - 8年)。9例患者在移植骨与宿主骨交界处愈合失败。5例患者发生假体柄骨折,19例患者发生晚期感染,3例患者发生无菌性松动。1例患者发生骨折,2例患者发生假体下沉。
肿瘤型假体重建在膝关节周围肿瘤切除后可提供最佳膝关节功能,复发率可接受。然而,由于并发症发生率高,肿瘤型假体仍需进一步改进。