异体半髁关节移植治疗膝关节周围骨巨细胞瘤的临床疗效#br#

摘要：目的　探讨瘤段切除联合同种异体骨移植治疗膝关节骨巨细胞瘤（GCTB）的疗效。方法　选取我院2010年6月—2017年2月收治的22例膝关节GCTB患者。所有患者均采用瘤段切除联合同种异体骨移植治疗。术后应用美国骨与软组织肿瘤协会（MSTS）评分评估患者下肢功能，Kellgren-Lawrence分级评估膝骨关节炎程度，Mankin分级法评价术后优良率。同时对患者进行随访，统计术后并发症及复发情况。结果　22例中男10例，女12例；平均年龄（33.91±7.12）岁；GCTB部位：股骨下端8例，胫骨上端14例；Campanicci等级：Ⅱ级14例，Ⅲ级8例。术后患者MSTS评分较术前明显提高（23.73±2.16 vs. 12.82±3.22，t=10.818，P＜0.05）；Mankin分级优良率90.9%；Kellgren-Lawrence分级KL0级10例，KL1级10例，KL2级2例。患者均获得随访，随访时间25～34个月，平均（30.0±2.6）个月，随访期间出现术后关节退行性变加重11例，关节积液2例，异体排斥2例，无一例复发。结论　瘤段切除联合同种异体骨移植治疗膝关节GCTB患者效果较好，术后膝关节功能可恢复到满意状态。

Clinical study of segmental resection combined with allogeneic bone transplantation in giant cell tumors of bone around knee joint

Abstract：Objective　To investigate the effect of segmental resection combined with allogeneic bone transplantation in the treatment of giant cell tumor of bone (GCTB) around knee joint. Methods　A total of 22 patients with GCTB of knee joint admitted to our hospital from June 2010 to February 2017 were selected. All patients were treated with tumor resection combined with allogeneic bone transplantation. The American Bone and Soft Tissue Tumor Society (MSTS) score was used to evaluate the lower limb function of patients after surgery. Kellgren-Lawrence classification was used to evaluate the degree of knee osteoarthritis. The Mankin classification method was used to evaluate the postoperative excellent and good rate. At the same time, the patients were followed up, and postoperative complications and recurrence were counted. Results　There were 10 males and 12 females in 22 patients. The average age was (33.91±7.12) years. The location of GCTB: there were 8 cases at the lower femur, 14 cases of upper tibia. Campanicci grade: there were 14 cases of grade Ⅱ, 8 cases of grade Ⅲ. The MSTS score was significantly higher in patients after operation than that of preoperation (23.73±2.16 vs. 12.82±3.22, t=10.818, P＜0.05). The excellent and good rate of Mankin classification was 90.9%. Kellgren-Lawrence classification: there were 10 cases of KL 0, 10 cases of KL 1 and 2 cases of KL 2. All patients were followed up for 25 to 34 months, with an average of (30.0±2.6) months. During the follow-up period, there were 11 cases of postoperative joint degeneration aggravated, 2 cases of joint effusion, 2 cases of allogeneic rejection, and no recurrence. Conclusion　Tumor resection combined with allogeneic bone transplantation is effective in the treatment of patients with knee GCTB, and the knee function can be restored to a satisfactory state after surgery.