Capanna R, Biagini R, Ruggieri P, Bettelli G, Casadei R, Campanacci M
1st Orthopaedic Clinic, Istituto Rizzoli, Bologna, Italy.
Int Orthop. 1989;13(4):253-8. doi: 10.1007/BF00268507.
A temporary arthrodesis of the knee, using an intramedullary Küntscher rod and bone cement, was carried out in 76 patients after resection of tumours of the distal femur or proximal tibia. In contrast to primary arthrodesis with bone grafting, this procedure allows the patient to bear weight on a stable limb a few days after operation, reduces the risk of infection and avoids the negative effect of chemotherapy on graft incorporation. In 12 cases (16%) the implant failed mechanically by fracture, or by bending or migration of the rod, at from 13 to 54 months after operation. Deep infection occurred in 11 patients (14%). A second reconstruction was carried out in 14 patients, 10 using Kotz prostheses and 4 arthrodeses with bone grafting. The operation we describe has advantages for patients with high grade tumours which require chemotherapy and resection-arthrodesis of the knee joint.
对76例股骨远端或胫骨近端肿瘤切除术后的患者,采用髓内Küntscher棒和骨水泥进行了膝关节临时关节固定术。与采用植骨的一期关节固定术不同,该手术可使患者在术后数天就能在稳定的肢体上负重,降低感染风险,并避免化疗对植骨融合的负面影响。12例(16%)患者的植入物在术后13至54个月出现机械性失败,表现为棒体骨折、弯曲或移位。11例患者(14%)发生深部感染。14例患者进行了二次重建,其中10例使用Kotz假体,4例采用植骨关节固定术。我们所描述的手术对于需要化疗且需行膝关节切除关节固定术的高级别肿瘤患者具有优势。