Division of Orthopedic Oncology and Septic Surgery, Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
Arch Orthop Trauma Surg. 2011 Jan;131(1):45-52. doi: 10.1007/s00402-010-1099-y. Epub 2010 Apr 3.
The aim of this study was the investigation of radiological and clinical long-term results after surgery for chondroblastoma in a single orthopedic oncological center.
As much as 24 patients were enrolled in the study using an in-house tumor data-base (age, sex, patient history, clinical symptoms, type of surgery, complications, and histological results), radiological findings (localization/size of the lesion, Lodwick-classification, Enneking-stages, and local recurrence), and clinical investigation (Enneking score). Mean follow-up was 8 years.
Preferred sites were the knee-joint (distal femur 6, proximal tibia 6), followed by the proximal humerus (8), and the proximal femur. As much as 3 lesions were judged inactive, 13 active, and 8 aggressive. Apart from one case, all lesions were treated by curettage and filling of the defect by bone cement and/or cancellous bone chips. Only one patient suffered local recurrence after primary resection of the tumor (4.2%). About 87.5% of our patients reached a very good or good functional result (Enneking score 28-30).
Our results further support curettage and defect filling even of active/aggressive chondroblastoma. If performed betimes, the surgical therapeutic concept of accurate intralesional curettage with or without local adjuvant therapy and defect packing with cancellous bone grafts and/or bone cement assures a high chance of joint preservation along with a low rate of recurrence and good functional long-term results.
本研究旨在调查单骨科肿瘤中心软骨母细胞瘤手术后的影像学和临床长期结果。
使用内部肿瘤数据库（年龄、性别、病史、临床症状、手术类型、并发症和组织学结果）、影像学发现（病变的定位/大小、Lodwick 分类、Enneking 分期和局部复发）和临床调查（Enneking 评分），对 24 名患者进行了研究。平均随访 8 年。
首选部位为膝关节（股骨远端 6 例，胫骨近端 6 例），其次是肱骨头（8 例）和股骨近端。多达 3 个病变被判断为不活跃，13 个为活跃，8 个为侵袭性。除 1 例外，所有病变均采用刮除术治疗，并用骨水泥和/或松质骨颗粒填充缺损。只有 1 例患者在肿瘤初次切除后出现局部复发（4.2%）。我们的患者中约有 87.5%达到了非常好或良好的功能结果（Enneking 评分 28-30）。
我们的结果进一步支持刮除术和缺损填充，即使是对于活跃/侵袭性软骨母细胞瘤。如果及时进行，准确的肿瘤内刮除术的手术治疗概念，辅以局部辅助治疗和松质骨移植物和/或骨水泥填充缺损，可确保关节保留的高几率，复发率低，功能长期结果良好。
