肿瘤型人工膝关节假体置换术的疗效影响因素分析

目的探讨膝关节周围恶性骨肿瘤患者肿瘤型人工膝关节假体置换术后疗效影响因素分析。方法选取2014年5月至2021年7月于上海市宝山区罗店医院收治的52例膝关节周围恶性骨肿瘤患者,所有患者均接受肿瘤型人工膝关节假体置换术治疗。根据Enneking骨骼肌肉肿瘤术后评分量表得出临床疗效后,通过Logistic回归判断患者性别、年龄、肿瘤类型、肿瘤分期、病变累及部位、截骨长度和假体类型等临床资料是否为影响因素。结果 52例膝关节周围恶性骨肿瘤患者,经肿瘤型人工膝关节假体置换术治疗后,显效21例,有效19例,无效12例,总体有效率为76.9%(40/52)。临床疗效与患者性别、年龄、肿瘤类型、病变累及部位和假体类型均不相关,差异无统计学意义(P> 0.05),与肿瘤分期、截骨长度显著相关,差异均有统计学意义(均P <0.05)。肿瘤分期为影响肿瘤型人工膝关节假体置换术疗效的因素,差异有统计学意义(P <0.05);截骨长度不是影响肿瘤型人工膝关节假体置换术疗效的因素,差异无统计学意义(P> 0.05)。52例患者出现3例感染、1例假体松动、2例关节挛缩,未发生下肢深静脉血栓和肿瘤局部复发,并发症发生率为15.4%(8/52)。结论膝关节周围恶性骨肿瘤患者肿瘤型人工膝关节假体置换术后疗效与肿瘤进展有关,越早进行手术,减少术后并发症,能有效改善患者生活质量,提高患者预后。

Factors influencing the treatment efficacy of prosthetic knee replacement in patients with malignant bone tumors around the knee joint

Objective To explore the factors influencing the treatment efficacy of prosthetic knee joint replacement in patients with malignant bone tumors around the knee joint. Methods A total of 52 patients with malignant bone tumors around the knee joint who were admitted to Luodian Hospital were selected from May 2014 to July 2021. All patients received prosthetic knee joint replacement. Enneking skeletal muscle tumor postoperative score scale was used to obtain the clinical efficacy,and then logistic regression was used to determine whether gender,age,tumor type,tumor stage,lesion location,osteotomy length,prosthesis type and other clinical data were influencing factors. Results In the 52 patients with malignant bone tumors around the knee joint,prosthetic knee joint replacement were markedly effective in 21 patients,effective in 19 patients,and ineffective in 12 patients. The overall effective rate was 76. 9%(40/52). The clinical efficacy was not associated with gender,age,types of tumor,lesion location and types of prosthesis(P > 0. 05). Rather it was significantly associated with tumor staging and osteotomy length(all P < 0. 05).Tumor staging was a factor influencing the efficacy of replacement,and the length of osteotomy was not a factor influencing the efficacy of replacement. Of the 52 patients,3 patients had infection,1 patient had a loose prosthesis,2 patients had joint contracture,and no deep vein thrombosis of lower limbs and local tumor recurrence occurred. The incidence of complications was 15. 4%(8/52). Conclusion The treatment efficacy of prosthetic knee joint replacement is associated with tumor progression in patients with bone tumors around the knee joint. Early operation can reduce postoperative complications and effectively improve the quality of life and prognosis.