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导航辅助手术治疗股骨头成软骨细胞瘤:一例报告。

Navigation-assisted surgery for chondroblastoma arising in the femoral head: A case report.

作者信息

Maru Takanori, Imanishi Jungo, Torigoe Tomoaki, Saita Kazuo, Kadono Yuho, Yazawa Yasuo

机构信息

Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Japan; Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Japan.

Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Japan; Department of Orthopaedic Surgery, Saitama Medical University Hospital, Japan.

出版信息

Int J Surg Case Rep. 2020;70:8-12. doi: 10.1016/j.ijscr.2020.03.049. Epub 2020 Apr 19.

Abstract

INTRODUCTION

Surgery for chondroblastoma in the femoral head is challenging due to its inaccessibility, with high risk of local recurrence and poor functional outcomes reported. We herein report the first case of chondroblastoma in the femoral head treated by navigation-assisted surgery.

PRESENTATION OF CASE

A 12-year-old girl presented with persistent left hip pain and limited hip range of motion. Imaging studies revealed a well-defined osteolytic lesion in the left femoral head accompanied by extensive intra-osseous oedematous change. The bone lesion was radiologically diagnosed as chondroblastoma. With navigation assistance, curettage was performed via the anterior approach. The tumor was fully accessible from the femoral neck. After curettage, the bony defect was filled with bone substitute. The pathological diagnosis was chondroblastoma. The post-operative course was uneventful. Thirty months postoperatively, the patient was free of pain with full hip range of motion, and MR images showed no evidence of recurrence or osteonecrosis.

DISCUSSION

This case is the first to use a navigation system for the treatment of chondroblastoma in the femoral head. The navigation system can minimize damage to intact structures and increase the efficiency of curettage by visualizing access to the tumor.

CONCLUSION

Navigation assistance is an optimal surgical option for chondroblastoma in the femoral head.

摘要

引言

由于股骨头软骨母细胞瘤难以触及,其手术具有挑战性,据报道局部复发风险高且功能预后差。我们在此报告首例通过导航辅助手术治疗的股骨头软骨母细胞瘤病例。

病例介绍

一名12岁女孩出现持续的左髋部疼痛和髋关节活动范围受限。影像学检查显示左股骨头有一个边界清晰的溶骨性病变,并伴有广泛的骨内水肿改变。该骨病变经放射学诊断为软骨母细胞瘤。在导航辅助下,通过前路进行刮除术。肿瘤可从股骨颈完全暴露。刮除术后,骨缺损用骨替代物填充。病理诊断为软骨母细胞瘤。术后过程顺利。术后30个月,患者无疼痛,髋关节活动范围正常,磁共振成像显示无复发或骨坏死迹象。

讨论

该病例是首例使用导航系统治疗股骨头软骨母细胞瘤。导航系统可通过可视化进入肿瘤的路径,将对完整结构的损伤降至最低,并提高刮除效率。

结论

导航辅助是股骨头软骨母细胞瘤的最佳手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b53/7183096/6deb0ddbf96e/gr1.jpg

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