绞链式全膝关节置换术在治疗股骨下端恶性骨肿瘤中的应用价值

目的探讨绞链式全膝关节置换手术在治疗股骨下端恶性骨肿瘤中的应用价值。方法选取2008年1月至2013年1月间收治的62例股骨下端恶性骨肿瘤患者,随机分为试验组(31例)和对照组(31例)。试验组患者采用铰链式全膝关节置换术治疗,对照组患者采用常规非绞链式全膝关节置换术治疗。手术后对两组患者进行随访,比较两组患者Neer评分情况、临床效果和并发症发生情况。结果试验组患者术后Neer评分明显优于对照组,试验组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。试验组患者术后出现如脱位、头坏死、关节感染、异位骨化等并发症的总发生率低于对照组患者,差异有统计学意义(P<0.05)。结论绞链式全膝关节置换术治疗股骨下端恶性骨肿瘤虽存在一些并发症,但其较常规非绞链式全膝关节置换术的治疗效果好,患者Neer评分情况好,具有一定临床优势,值得在临床上推广应用。

The application value of hinged total knee arthroplasty in the treatment of patients with distal femur malignant bone tumor

Objective To explore and analyze the application value of hinged total knee arthroplas- ty in the treatment of patients with distal femur malignant bone tumor. Methods We chose 62 cases of pa- tients with distal femur malignant bone tumors from January 2008 to January 2013. All patients were ran- domized grouped to experimental group（ 31 cases） and control group（ 31 cases）. Patients in A group were given hinged total knee arthroplasty, patients in B group were treated with conventional non-hinged total knee arthroplasty. Patients were followed up, the Neer score and clinical effects were recorded and com- pareed between these two groups, aiming to investigate the incidence of complications after treatment in these two groups. Results Postoperative Neer score of patients in the experimental group was better than that in the control group. Total efficiency of the experimental group was higher than that of the control group （ P 〈 0. 05 ） ; and overall incidence of complications which included dislocation, head necrosis, joint infec- tion, ectopic ossification in the experimental group was less than the control group（ P 〈 0. 05 ）. Conclusions Although the hinged knee arthroplasty existed some complications in treating distal femur malignant bone tumors, but its treatment effect was better than conventional non-hinged total knee arthroplasty. It had much better Neer score with certain clinical advantages, it was worthy to be used in the clinical practice.