旋转铰链式膝关节假体置换治疗恶性骨肿瘤

背景：在新的辅助化疗和人工假体设计的协助下，肢体恶性骨肿瘤的治疗效果得到大幅度提高，关节置换成为恶性骨肿瘤治疗的主要保肢方法 目的：观察旋转铰链式膝关节假体在恶性骨肿瘤保肢治疗中的疗效。 方法：选择2005-01/2009-10盐城市第一人民医院骨科收治的膝关节恶性骨肿瘤患者15例，均行旋转铰链式膝关节假体置换。置换后采用Enneking肢体肌肉骨骼肿瘤外科治疗重建置换后膝关节功能评估标准进行评估。 结果与结论：15例患者置换后获随访7~51个月。1例置换后出现感染并发症，血沉检查结果升高，经清创、关节松解和抗炎治疗后好转，关节功能得到恢复。置换后患者均未出现肿瘤复发和肺转移病例，无假体松动和体断裂出现。Enneking功能评估，肢体功能优7例(47%)，良5例(33%)，差3例(20%)，优良率达80%。提示应用旋转铰链式膝关节假体置换治疗膝关节恶性肿瘤效果良好，可以保留良好的肢体功能，是一种较为满意的保肢方法。

Efficacy of rotating hinged knee prosthesis replacement for the treatment of malignant bone tumors

BACKGROUND: Under new adjuvant chemotherapy and artificial false body design help, effects of body malignant bone cancer treatment can be greatly improved, and joint replacement becomes the main limb-salvage method for malignant bone cancer treatment. OBJECTIVE: To observe curative effect of rotating hinged knee prosthesis on malignant bone tumors limb-salvage treatment. METHODS: Totally 15 patients with knee malignant bone tumors were treated with prosthesis rotating hinged replacement from Department of Orthopedics, First People’s Hospital of Yancheng between January 2005 and October 2009. Postoperative Enneking musculoskeletal tumor by limb function after knee surgery reconstruction assessment standards were used for evaluation. RESULTS AND CONCLUSION: Totally 15 patients were followed-up for 7-51 months. Postoperative complications were found in one patient, check results of erythrocyte sedimentation rate was increased, after debridement, joint solution and anti-inflammatory treatment, joint function was restored. Postoperative tumor recurrence, lung metastasis, prosthesis loosening and fracture were not appeared in all the patients. Enneking function evaluation, limb function excellent for seven cases (46.7%), good for five cases (33.3%), poor for three cases (20.0%), excellent and good rate was 80%. It is indicated that the effect of rotating hinged knee prosthesis replacement for knee malignant tumor is well, which can keep good limb function and is a kind of relatively satisfactory limb-salvage method.