膝关节周围骨巨细胞瘤的手术治疗

目的:回顾性分析膝关节周围骨巨细胞瘤行手术治疗的病例,探讨骨巨细胞瘤手术病灶刮除与功能重建的方法与疗效。方法:膝关节周围骨巨细胞瘤21例,男15例,女6例;年龄6～72岁,平均43岁。股骨下端骨巨细胞瘤14例,胫骨上端骨巨细胞瘤7例。无症状偶然发现者2例,膝关节周围疼痛肿胀伴活动障碍者19例。除1例采用截肢术外,对8例儿童及青少年采用瘤体扩大刮除、灭活、植骨治疗;对12例18岁以上成年人采用肿瘤扩大刮除、灭活、植骨及骨水泥充填,钢板内固定治疗。结果:20例获随访,随访时间6～48个月,平均42个月。术后肿瘤复发3例,切口液化坏死1例。膝关节功能按李强一等标准评价:优11例,良6例,差3例。结论:对膝关节周围骨巨细胞瘤采用肿瘤扩大刮除、灭活、植骨或骨水泥充填重建功能,降低了肿瘤的复发率,并最大程度地保留了肢体功能。

Operative treatment for giant cell tumor of bone around the knee joint

Objective:To explore the operative methods and outcomes of giant cell tumor of bone with tumor curettage and function reconstruction.Methods:Twenty-one patients(14 in distal femur and 7 in proximal tibia;15 males and 6 females;the average age of 43 years from 6 to 72 years)with giant cell tumor of bone of the distal femur and proximal tibia were treated by two methods of surgical procedures respectively except 1 amputation.Two cases with no complaint,19 csaes with pain,swelling and limited activity in the knee.Eight cases of children and adolescent were with expanded tumor curettage and tumor cell killing and bone transplantation,12 adult cases were with plate fixation and methacrylate cement filling after above operatiion.Results:All the cases were followed up for 6 to 48 months with mean 42 months.Three cases recurrenced and 1 case wound was colliquative necrosis.According to LI Qiang-yi' standard,the knee joint function results were excellent in 11 cases,good in 6 cases and poor in 3 cases.Conclusion:The giant cell tumor of bone around the knee joint can be cured with expanded tumor curettage and tumor cell killing as well as bone transplantation or methacrylate cement filling for function reconstruction,this treatment method is simple and effective.