Härle A, Wuisman P
Orthop. Universitätsklinik, Münster.
Z Orthop Ihre Grenzgeb. 1989 Jul-Aug;127(4):382-6. doi: 10.1055/s-2008-1044682.
Curettage with simultaneous bone transplantation is followed by a recurrence rate of 20-60%. In a follow-up of own cases up to 36 years after treatment recurrence was roughly 50%. In the last 10 years we changed to on other treatment procedure, namely optical controlled curettage with temporary cementation. To prevent further damage to the preexisting destabilization of the periarticular cortical bone, tumor excision is done through a small bone window, using a cold lighted mirror to achieve complete curettage. The cavity is then filled with bone cement, which is left in place for 3 months. When at that time there are no signs for tumor persistence, the cement is removed and bone reconstruction performed. An analysis of 17 cases treated this way showed a clearly smaller recurrence rate of 6%; this difference was statistically significant when applying the Kaplan-Meier test.
刮除术联合同期骨移植后的复发率为20% - 60%。在对我们自己的病例进行长达36年的随访中，复发率约为50%。在过去10年里，我们改用了另一种治疗方法，即光学控制刮除术并临时植骨水泥。为防止进一步破坏关节周围皮质骨已有的稳定性，通过一个小骨窗进行肿瘤切除，使用冷光镜以实现彻底刮除。然后用骨水泥填充骨腔，并留置3个月。如果届时没有肿瘤持续存在的迹象，则取出骨水泥并进行骨重建。对17例采用这种方法治疗的病例进行分析显示，复发率明显降低至6%；应用Kaplan - Meier检验时，这种差异具有统计学意义。
