Zhu Wei, Ma Qi, Bian Yanyan, Zhuang Qianyu, Xia Zenan, Jin Jin, Weng Xisheng
Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
PLoS One. 2017 May 17;12(5):e0177835. doi: 10.1371/journal.pone.0177835. eCollection 2017.
Tumor-induced osteomalacia (TIO) may result in a better prognosis after complete resection of the causative neoplasm. However, tumors located proximal to the articular surface of the metaphysis remain largely uninvestigated.
A retrospective study of sixteen patients was undertaken to evaluate treatment of tumors with joint arthroplasty and tumor resection. The bone metabolism index, hip/knee joint function, arthroplasty complications and symptoms were followed up for at least 12 months in each patient.
All patients presented with neoplasms situated in the articular surface of the metaphysis, with 13 cases undergoing hip arthroplasty and 3 undergoing knee arthroplasty. Treatment of the tumors with joint arthroplasty and tumor resection significantly and rapidly ameliorate bone metabolism indexes in patients with TIO (p<0.01), with no identified tumor recurrence. The joint function evaluation score was improved in 15 patients (93.75%). Complications in these patients included post-operative pain, joint squeaking and secondary hyperparathyroidism.
Joint arthroplasty that includes tumor-expanding resection appears to be a safe and appropriate method for the treatment of TIO patients with a neoplasm located in the metaphysis proximal to the articular surface.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
肿瘤性骨软化症（TIO）在彻底切除致病肿瘤后可能有较好的预后。然而，位于干骺端关节面近端的肿瘤在很大程度上仍未得到充分研究。
对16例患者进行回顾性研究，以评估采用关节置换术和肿瘤切除术治疗肿瘤的效果。对每位患者的骨代谢指标、髋/膝关节功能、关节置换术并发症及症状进行了至少12个月的随访。
所有患者的肿瘤均位于干骺端关节面，其中13例行髋关节置换术，3例行膝关节置换术。采用关节置换术和肿瘤切除术治疗TIO患者，可显著且迅速地改善骨代谢指标（p<0.01），且未发现肿瘤复发。15例患者（93.75%）的关节功能评估得分有所提高。这些患者的并发症包括术后疼痛、关节摩擦音和继发性甲状旁腺功能亢进。
包括肿瘤扩大切除的关节置换术似乎是治疗肿瘤位于关节面近端干骺端的TIO患者的一种安全且合适的方法。
治疗性III级。有关证据水平的完整描述，请参阅作者指南。
