临近膝关节CampanacciⅢ级骨巨细胞瘤的手术治疗策略

目的探讨病灶刮除、蒸馏水＋氯化锌灭活、抗菌素骨水泥填充、钢板螺钉内固定手术方法治疗临近膝关节CampanacciⅢ级骨巨细胞瘤的有效性。方法回顾分析2004年3月至2009年11月收治的13例临近膝关节CampanacciⅢ级骨巨细胞瘤患者，入院后均经病理活检确诊后采取上述手术方法治疗。所有患者均获得随访，随访时间1．5—7．2年，平均随访5．1年。随访时评估受试者HSS评分、VAS评分及影像学资料评估。结果所有患者术后均未发现复发，无骨水泥及内固定失效问题，且HSS评分、VAS评分较术前明显改善。结论病灶刮除、瘤壁蒸馏水＋氯化锌灭活、抗菌素骨水泥填充、钢板螺钉内固定是治疗临近膝关节CampanacciⅢ级骨巨细胞瘤的一种有效、复发率较低的手术方法。

Surgical strategy for giant cell tumor (GCT) close to knee joint at Campanacci III

Objective To evaluate the effectiveness of the lesion curettage, inactivation by distilled water and zinc chloride, filling with antibiotic bone cement and internal fixation with steel plates and screws for the treatment of giant cell tumor （GCT） close to the knee joint at Campanacci III. Methods From March 2004 to November 2009, a consecutive series of 13 patients with GCT close to the knee joint at Campanacci III were treated with above- mentioned method after final diagnosis by biopsy. All patients were followed up .The average follow-up period was 5.1 years （range; 1.5-7.2 years）. The HSS score, the VAS score and imaging data of the patients were analysed during the follow-up. Results No recurrence, absence of cement or internal fixation failure was found in patients postoperatively. The patients obtained significant improvement in HSS and VAS than those preoperatively. Conclusions The surgical treatment with lesion curettage, inactivation by distilled water and zinc chloride, filling with antibiotic bone cement and internal fixation with steel plates and screws is an effective strategy with low recurrence rate for GCT close to knee joint at Campanacci III.