大块异体骨联合自体骨髓移植修复股骨上段肿瘤切除后缺损

背景:由于骨肿瘤切除造成的骨组织缺损是临床面临的难题之一,而如何修复缺损是骨科领域的热点问题.目的:探讨采用大块异体骨联合自体骨髓移植治疗股骨上段肿瘤的临床应用及疗效.方法:于2000-07/2005-06采用辐照冻存的大块异体骨联合自体骨髓移植治疗股骨上段良性肿瘤切除后遗留大块骨缺损12例,手术采用类似脊柱的"蛋壳"技术,掏空股骨头,保留股骨头圆韧带及头的皮质骨,尽量保留股骨头的1/3的血供,应用大块异体骨联合自体骨髓移植加内固定治疗.结果与结论:患者术后随访6~11年.术后所有12例患者的大块异体骨联合自体骨髓在X射线中均显示整合血管化良好,骨小梁通过自体骨.MSTS93总体平均评分为26.33分,患者肢体功能总的优良率为83.3%.提示大块异体骨联合自体骨髓移植是修复股骨上段肿瘤切除后骨大块缺损的有效方法,并能充分整合成周围的自体骨.

Massive bone allograft combined with autologous bone marrow transplantation for proximal femoral defects resulting from tumor resection

BACKGROUND:Bone defects due to bone tumor resection are difficult problems in clinic,and how to repair bone defects is a hotspot in the orthopedics.OBJECTIVE:To discuss the clinical application and effect of massive bone allograft combined with autologous bone marrow transplantation for the defects after proximal femoral tumor resection.METHODS:From July 2000 to June 2005,a total of 12 patients with massive bone defects after proximal femoral tumor resections received irradiated frozen massive bone allograft combined with autologous bone marrow transplantation.The surgery used "eggshell" technology similar to the spinal cord,femoral head was empty,the round ligament and cortical bone of the femoral head was kept,as well as one third blood supply of the femoral head.Massive bone allograft combined with autologous bone marrow transplantation and internal fixation was performed.RESULTS AND CONCLUSION:Patients were followed-up regularly for 6-11 years after operation.The X-ray film showed that vascularization and bone trabeculae crossing the host bone could be seen in 12 cases.In addition,the mean MSTS93 score of 12 patients was 26.33,and the excellent rate of limb function was 83.3%.Massive bone allograft combined with autologous bone marrow transplantation is an effective method for proximal femoral defects resulting from tumor resection and can integrate with the surrounding host bone.