Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Bone Joint J. 2013 Sep;95-B(9):1275-9. doi: 10.1302/0301-620X.95B9.31433.
The aim of this study was to assess a specific protocol for the treatment of patients with a parosteal osteosarcoma of the distal femur with limb salvage involving hemicortical resection and reconstruction using recycled pasteurised autograft and internal fixation. Between January 2000 and January 2010, 13 patients with a mean age of 26.5 years (17 to 39) underwent this procedure. All the tumours were staged according to Enneking's criteria: there were eight stage IA tumours and five stage IB tumours. The mean follow-up was 101.6 months (58 to 142), and mean post-operative Musculoskeletal Tumour Society functional score was 88.6% (80% to 100%) at the final follow-up. All the patients had achieved bony union; the mean time to union was 11.2 months (6 to 18). Local recurrence occurred in one patient 27 months post-operatively. No patient had a pulmonary metastasis. A hemicortical procedure for the treatment of a parosteal osteosarcoma is safe and effective. Precise pre-operative planning using MRI is essential in order to define the margins of resection. Although it is a technically demanding procedure, gratifying results make it worthwhile for selected patients.
本研究旨在评估一种特定的治疗方案，即通过半侧皮质骨切除和使用再处理的巴氏消毒自体骨移植物及内固定进行重建来保肢治疗股骨远端骨旁骨肉瘤。2000 年 1 月至 2010 年 1 月期间，有 13 名平均年龄为 26.5 岁（17 岁至 39 岁）的患者接受了这种治疗。所有肿瘤均根据 Enneking 分期标准进行分期：8 个 IA 期肿瘤和 5 个 IB 期肿瘤。平均随访时间为 101.6 个月（58 至 142），末次随访时的平均术后肌肉骨骼肿瘤学会功能评分 88.6%（80%至 100%）。所有患者均实现了骨性愈合；平均愈合时间为 11.2 个月（6 至 18）。1 例患者术后 27 个月出现局部复发。无患者发生肺转移。半侧皮质骨切除治疗骨旁骨肉瘤是安全有效的。为了确定切除的边界，术前需要使用 MRI 进行精确的规划。虽然这是一项技术要求较高的手术，但对于选定的患者来说，满意的结果是值得的。
