Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona.
The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona.
J Knee Surg. 2022 May;35(6):585-596. doi: 10.1055/s-0042-1743221. Epub 2022 Feb 18.
Primary bone sarcomas and aggressive benign bone tumors are relatively rare. It is essential to recognize features that are concerning for these aggressive tumors based on a patient's history, physical exam, and radiographs. Physicians and other health care providers should have a high suspicion for these tumors and promptly refer these patients to orthopaedic oncologists. A multidisciplinary, team-based approach is required to obtain an accurate diagnosis and provide comprehensive care. This review discussed the appropriate work-up, biopsy principles, relevant peri-operative medical management, and surgical treatment options for patients with aggressive primary bone tumors around the knee. Primary bone sarcomas (osteosarcoma and chondrosarcoma) and aggressive benign bone tumors (giant cell tumor, chondroblastoma, and chondromyxoid fibroma) that have a predilection to the distal femur and proximal tibia are the focus of this review.
原发性骨肉瘤和侵袭性良性骨肿瘤相对少见。根据患者的病史、体格检查和影像学检查,识别出这些侵袭性肿瘤的特征至关重要。医生和其他医疗保健提供者应该对这些肿瘤保持高度怀疑,并及时将这些患者转介给骨肿瘤科医生。需要采用多学科、团队合作的方法来获得准确的诊断并提供全面的治疗。本文讨论了膝关节周围侵袭性原发性骨肿瘤患者的适当检查、活检原则、相关围手术期医疗管理以及手术治疗选择。本文重点讨论了好发于股骨远端和胫骨近端的原发性骨肉瘤(骨肉瘤和软骨肉瘤)和侵袭性良性骨肿瘤(骨巨细胞瘤、软骨母细胞瘤和软骨黏液样纤维瘤)。