Sakamoto Akio
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Knee Surg. 2017 Jan;30(1):75-77. doi: 10.1055/s-0036-1579789. Epub 2016 Mar 28.
Giant cell tumor of bone is a locally aggressive metaphyseal lesion extending to the epiphysis, mostly occurring around the knee joint. Reconstruction to preserve the joint is difficult when there is little subarticular bone. Four such cases with a giant cell tumor of bone around the knee joint were treated by curettage and reconstruction using β-tricalcium phosphate (β-TCP). Block-shaped β-TCP with high mechanical strength (hard-type β-TCP) was implanted into the cavity, while standard β-TCP particles were put into the subarticular space. Exercise to promote improved range of motion was performed after the operation. The hard-type β-TCP is mechanically stronger than cancellous bone. Therefore, weight bearing can start around 3 months postoperatively when bone has been incorporated into the subarticular area but before complete bone incorporation into the lesion. This reconstructive procedure also provides excellent knee function.
骨巨细胞瘤是一种具有局部侵袭性的干骺端病变，可延伸至骨骺，多发生于膝关节周围。当关节下骨量很少时，保留关节的重建手术很困难。我们对4例膝关节周围骨巨细胞瘤患者采用刮除术并使用β-磷酸三钙（β-TCP）进行重建。将具有高机械强度的块状β-TCP（硬型β-TCP）植入骨腔，而将标准β-TCP颗粒放入关节下间隙。术后进行锻炼以促进活动范围的改善。硬型β-TCP的机械强度比松质骨更强。因此，当骨已长入关节下区域但尚未完全长入病变时，术后约3个月即可开始负重。这种重建方法也能提供出色的膝关节功能。
