Frink S J, Snearly W, Parsons T W
Department of Orthopaedic Surgery, Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas 78236-5300, USA.
Am J Knee Surg. 1998 Fall;11(4):257-66.
The knee is the most common location for malignant bony tumors as well as a number of soft-tissue sarcomas. The clinical presentation of these lesions usually involves pain and swelling, often associated with a palpable mass. This can occur rapidly or take a more indolent course. Proper evaluation and staging prior to biopsy of these tumors is necessary. This should be done by a surgeon experienced in the treatment of these tumors and at a facility where a multispecialty team can provide patient care. The primary surgical choices for treating malignant musculoskeletal tumors are limb salvage and amputation. One of the major difficulties in performing limb salvage about the knee is the lack of soft-tissue coverage after resection. Local or even free flaps are often necessary. Additionally, reattachment of the extensor mechanism is necessary. These problems and the use of allografts often lead to a high incidence of complications including infection, wound breakdown, allograft fracture, or extensor mechanism problems with resultant poor functional result.
膝关节是恶性骨肿瘤以及多种软组织肉瘤最常见的发病部位。这些病变的临床表现通常包括疼痛和肿胀，常伴有可触及的肿块。这种情况可能迅速发生，也可能病程较为隐匿。在对这些肿瘤进行活检之前，进行恰当的评估和分期是必要的。这应由在治疗这些肿瘤方面经验丰富的外科医生在一个多专科团队能够提供患者护理的机构来完成。治疗恶性肌肉骨骼肿瘤的主要手术选择是保肢和截肢。在膝关节周围进行保肢手术的一个主要困难是切除后缺乏软组织覆盖。局部甚至游离皮瓣通常是必要的。此外，伸肌机制的重新附着也是必要的。这些问题以及同种异体骨的使用常常导致并发症的高发生率，包括感染、伤口裂开、同种异体骨骨折或伸肌机制问题，从而导致功能结果不佳。
