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膝关节周围 Campanacci Ⅱ级或Ⅲ级巨细胞瘤广泛刮除后,采用带血管腓骨自体骨移植和松质骨异体骨进行联合挽救性及生物修复大块骨缺损。

Joint Salvage and Biological Repair of Massive-Cavity Bone Defects After Extensive Curettage of Campanacci Grade II or III Giant Cell Tumor Around the Knee With Vascularized Fibular Autograft and Cancellous Allograft.

机构信息

From the Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China.

出版信息

Ann Plast Surg. 2021 Nov 1;87(5):537-541. doi: 10.1097/SAP.0000000000002893.

Abstract

OBJECTIVE

The aim of the study was to report the clinical outcomes of repair of massive-cavity bone defects after extensive curettage of Campanacci grade II or III giant cell tumor (GCT) around knee with vascularized fibular autograft and cancellous allograft.

METHODS

There were 12 consecutive patients with Campanacci grade II or III GCT around knee treated in our department between 2004 and 2016. All the patients underwent clinical evaluation, plain radiography, and/or magnetic resonance imaging of the knee right after admission. To preserve their knee function, we repaired the massive-cavity bone defects after extensive curettage of GCT by vascularized fibular autografts and cancellous allograft. All the patients were evaluated through clinical examinations, plain radiography of the knee and chest, and Musculoskeletal Tumor Society (MSTS) scores of the lower extremity in the follow-ups.

RESULTS

The follow-up ranged from 1.5 to 12.0 years (mean, 4.2 years). There were no local recurrences or lung metastasis in any of the 12 patients at the last follow-up. Ten patients had no pain or experienced occasional pain, and 9 were able to resume their previous work. The mean range of motion of knee flexion was 117 degrees, and the extension was -6 degrees. The mean MSTS score was 24.7, and a total of 10 patients had excellent or good MSTS scores.

CONCLUSIONS

It is reliable to achieve knee joint salvage and repair massive-cavity bone defects after extensive curettage with vascularized fibular autograft and cancellous allograft in patients with Campanacci grade II or III GCT around the knee.

摘要

目的

本研究旨在报告 12 例膝关节周围 Campanacci Ⅱ级或Ⅲ级骨巨细胞瘤(GCT)患者,经广泛刮除后,采用带血管腓骨自体骨与松质骨异体骨移植修复大块骨缺损的临床疗效。

方法

2004 年至 2016 年,我科共收治 12 例膝关节周围 Campanacci Ⅱ级或Ⅲ级 GCT 患者,所有患者入院后均行临床评估、膝关节正侧位 X 线片及(或)磁共振成像检查。为保留膝关节功能,我们采用带血管腓骨自体骨与松质骨异体骨移植修复 GCT 广泛刮除后的大块骨缺损。所有患者均通过临床检查、膝关节和胸部正侧位 X 线片及肌肉骨骼肿瘤学会(MSTS)下肢评分进行随访。

结果

随访时间 1.5 至 12.0 年,平均 4.2 年。末次随访时,12 例患者均未见局部复发或肺部转移。10 例患者无疼痛或偶有疼痛,9 例患者能恢复原工作。膝关节屈曲平均活动度为 117°,伸直平均活动度为-6°。MSTS 平均评分为 24.7 分,10 例患者 MSTS 评分优良。

结论

对于膝关节周围 Campanacci Ⅱ级或Ⅲ级 GCT 患者,采用带血管腓骨自体骨与松质骨异体骨移植修复广泛刮除后的大块骨缺损,可获得可靠的膝关节保肢效果。

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