Li Zhuoyu, Liu Weifeng, Niu Xiaohui, Jiang Chunyan, Zhang Qing
Peking University Fourth School of Clinical Medicine, Beijing, 100035, China.
Department of Orthopaedic Oncology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, China.
J Orthop Surg Res. 2025 Sep 24;20(1):827. doi: 10.1186/s13018-025-06252-7.
The purpose of this study was to investigate the clinical outcomes of joint-preserving endoprosthesis reconstruction for primary sarcomas about the knee.
A retrospective cohort study was conducted on 45 patients (21 males, 24 females) who underwent joint-preserving endoprosthesis reconstruction (JPER) for bone tumours about the knee between January 2009 and January 2023. The average age was 23.9 ± 15.1 years (range, 7-66 years) and the most common pathological type was osteosarcoma (34), followed by Ewing's sarcoma (5), adamantinoma (3), spindle cell sarcoma (2), and undifferentiated pleomorphic sarcoma (UPS, 1). There were 35 cases of tumors located in the femur and 10 cases located in the tibia. The oncological outcomes included local control, metastasis, progression-free survival, and overall survival. The functional outcomes were evaluated by the Musculoskeletal Tumour Society Score (MSTS-93).
45 patients were included in this retrospective study, and no patient were lost in the follow-up. The mean follow-up time was 105.3 ± 44.6 months (range, 15-183 months). Five patients (11.1%) died in the last follow-up. Four patients had local recurrences, and the mean interval between the index procedure to local recurrence was 25.5 months (range, 4-36 months). The 5-year and 10-year overall survival rate was 91.2% (95% CI 82.5%-99.9%) and 86.2% (95% CI 74.3%-98.1%), respectively. The 5-year and 10-year progression-free survival rate was 85.5% (95% CI 74.9%-96.1%) and 81.5% (95% CI 69.3%-93.7%), respectively. The average MSTS-93 score was 93% (range, 70-100%). The overall survivorship of the JPER was 84.4% (38/45) at an average of 8.7 years follow-up. Failure mechanisms included 4 infections (57%), 2 local tumour progression (29%), and one structural failure (14%) according to Henderson classification.
The joint-preserving endoprosthesis reconstruction (JPER) is a reliable technique to reconstruct massive bone defects after primary sarcoma resection about the knee with acceptable oncological outcomes, function, and satisfaction.
Level IV therapeutic study.
本研究旨在探讨保留关节的人工关节置换重建术治疗膝关节原发性肉瘤的临床疗效。
对2009年1月至2023年1月期间接受保留关节的人工关节置换重建术（JPER）治疗膝关节周围骨肿瘤的45例患者（21例男性，24例女性）进行回顾性队列研究。平均年龄为23.9±15.1岁（范围7 - 66岁），最常见的病理类型为骨肉瘤（34例），其次为尤因肉瘤（5例）、造釉细胞瘤（3例）、梭形细胞肉瘤（2例）和未分化多形性肉瘤（UPS，1例）。肿瘤位于股骨35例，位于胫骨10例。肿瘤学结局包括局部控制、转移、无进展生存期和总生存期。功能结局通过肌肉骨骼肿瘤学会评分（MSTS - 93）进行评估。
本回顾性研究纳入45例患者，随访期间无患者失访。平均随访时间为105.3±44.6个月（范围15 - 183个月）。在最后一次随访时有5例患者（11.1%）死亡。4例患者出现局部复发，初次手术至局部复发的平均间隔时间为25.5个月（范围4 - 36个月）。5年和10年总生存率分别为91.2%（95%CI 82.5% - 99.9%）和86.2%（95%CI 74.3% - 98.1%）。5年和10年无进展生存率分别为85.5%（95%CI 74.9% - 96.1%）和81.5%（95%CI 69.3% - 93.7%）。MSTS - 93平均评分为93%（范围70 - 1OO%）。平均随访8.7年时，JPER的总体假体生存率为84.4%（38/45）。根据亨德森分类，失败机制包括4例感染（57%）、2例局部肿瘤进展（29%）和1例结构失败（14%）。
保留关节的人工关节置换重建术（JPER）是一种可靠的技术，用于重建膝关节原发性肉瘤切除术后的大块骨缺损，具有可接受的肿瘤学结局、功能和满意度。
IV级治疗性研究。
