人工假体在膝关节周围骨肿瘤保肢治疗中的应用

目的：探讨对膝关节周围骨肿瘤切除后，采用人工全膝关节置换达到保肢的疗效。方法：1996—2000年共收治骨肿瘤患者11例，年龄18～55岁，其中恶性骨巨细胞瘤6例，骨肉瘤2例，软骨肉瘤2例，纤维肉瘤1例。股骨下端病变7例，胫骨上端病变4例。肢体功能重建方法为特制的人工全膝关节置换术。结果：本组11例经3～6年随访，8例无瘤存活，3例带瘤存活。术后肢体功能按Enneking评分系统评分，平均为21．5分，总优良率72．7％，其中股骨远端肿瘤术后平均为22．3分，胫骨近端肿瘤术后平均为20．0分。结论：采用特制的人工全膝关节置换术，能有效治疗膝关节周围低度恶性或恶性骨肿瘤，达到良好保肢效果。

Application of prosthesis replacement in limb salvage treatment of tumors at the knee

Objective:To investigate the clinical outcome of application of prosthetic knee replacement in limb salvage treatment of primary malignant tumor at the distal part of the femur and proximal part of the tibia.Methods:Data of 11 consecutive patients with tumors of the knee treated with prosthetic knee replacement from 1996 to 2000 were reviewed.The average age of these 11 patients was 33 8 years(range 18 to 55 years).There were 7 distal femoral and 4 proximal tibial replacements.The diagnoses of 11 patients were giant cell tumor in 6 cases,osteosarcoma in 2,chondrosarcoma in 2 and fibrosarcoma in 1.The reconstruction of limb function was total knee replacement with individualized prosthesis.Results:The duration of follow up ranged from 3 to 6 years.At the time of the last follow up,8 patients were disease free,3 were alive with metastatic disease.None of them developed local recurrences.According to Enneking score system,the mean functional score was 21 5 points and the excellent and good rate was 72 7%.Conclusion:Application of prosthetic knee replacement in limb salvage treatment of tumor at the knee is effective,especially for those with massive bone destruction.