Bini S A, Gill K, Johnston J O
University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco 94143-0728, USA.
Clin Orthop Relat Res. 1995 Dec(321):245-50.
A retrospective review was conducted of all consecutive giant cell tumors treated by the senior author (JOJ) between 1975 and 1990 using the technique of aggressive curettage through a large bone window followed by acrylic cement reconstruction. Steinmann pins were used as reinforcement bars within the methacrylate in large lesions. Thirty-eight patients with a mean followup of 5.2 years (range, 2-16 years) were identified. Three (8%) recurrences are reported. There were no infections or mechanical failures of the construct. Functional results were good to excellent in 84% of patients. Ninety-five percent of patients reported good or excellent stability, no deformity, and emotional acceptance of the procedure. The recurrence rate with this protocol (8%) approached that associated with wide resection or amputation (0%-5%), and was lower than that seen with simple curettage and bone grafting (27%-55%). Acrylic cement reconstruction is a safe and effective procedure that provides local adjuvant therapy and immediate stability for early rehabilitation. The authors emphasize the importance of aggressive curettage of the lesion through a large bone window and suggest the use of reinforcement bars within the cement for large defects.
对1975年至1990年间资深作者（JOJ）采用经大骨窗积极刮除术并随后进行丙烯酸骨水泥重建技术治疗的所有连续性骨巨细胞瘤进行了回顾性研究。在大的病变中，斯氏针被用作甲基丙烯酸酯内的加强棒。确定了38例患者，平均随访5.2年（范围2 - 16年）。报告了3例（8%）复发。未发生植入物感染或机械故障。84%的患者功能结果为良好至优秀。95%的患者报告稳定性良好或优秀，无畸形，且对手术在心理上能够接受。该方案的复发率（8%）接近广泛切除或截肢术的复发率（0% - 5%），且低于单纯刮除术和植骨术的复发率（27% - 55%）。丙烯酸骨水泥重建是一种安全有效的手术方法，可提供局部辅助治疗并为早期康复提供即时稳定性。作者强调经大骨窗对病变进行积极刮除的重要性，并建议在骨水泥内为大的骨缺损使用加强棒。
