人工假体置换在膝关节周围骨肉瘤治疗中的应用

目的探讨人工假体在膝关节周围骨肉瘤保肢术中的临床应用效果。方法对32例膝关节周围骨肉瘤患者行肿瘤段广泛性切除或根治性切除后行人工膝关节假体置换重建，术前术后均行新辅助化疗。结果32例均获得随访，时间6～72个月。无瘤2年生存者24例，无瘤5年生存者18例，5年总生存率为65．6％。28例患肢屈伸活动均为0°～100°，4例患肢屈伸活动为0°～60°。根据Enneking功能评定标准进行功能评估：优14例，良16例，可2例。结论膝关节周围骨肉瘤行广泛性或根治性切除，应用人工假体置换术重建膝关节，可以重建膝关节的结构，使膝关节功能达到较好的恢复，取得较好的治疗效果。

Prosthetic knee replacement for the treatment of osteosarcoma around the knee

Objective To discuss the clinical effects of limb salvage with artificial prosthetic knee replacement for osteosarcoma around the knee. Methods Limb salvage surgery with prosthetic knee replacement was performed in 32 patients with osteosarcoma around the knee. The reconstruction of limb function was total knee replacement with individualized prosthesis. Neoadjuvant chemotherapy was used in all the cases pre- and postoperatively. Results Thirty-two patients were followed up for 6 -72 months. 24 cases survived without tumor in 2 years and 18 in 5 years. The 5 years survive rate was 65.6%. The rang of extension and flexion was of knee activity was 0°～ 100° in 28 cases,and 0° - 60° in 4. The function of the knee were assessed by Enneking system. The results were graded as excellent in 14 patients,good in 16 cases,and fair in 2 cases. Conclusions It is effective for the treatment of osteosarcoma around the knee by extensive or radical resection and reconstruction by using prosthetic knee replacement.