摘要
[目的]探讨采用病灶内肿瘤扩大刮除、骨水泥填充并钢板内固定联合二磷酸盐治疗邻膝关节骨巨细胞瘤的临床应用可行性。[方法]回顾分析2008年1月~2010年6月本科治疗的16例邻膝关节骨巨细胞瘤。男7例,女9例,平均年龄38岁（27~78岁）。发病部位：股骨远端10例,胫骨近端6例。所有患者术前均经仔细评估确定肿瘤腔的完整性,术中仔细刮除肿瘤组织,应用磨钻及电刀处理瘤腔壁,骨水泥填充修复骨缺损,同时给予钢板内固定。术后均应用二膦酸盐类药物。[结果]本组患者全部获得随访,中位随访15个月,无局部复发及转移发生。参照Ennek ing肢体功能评分标准,本组患者平均得29分（27~30）分。复查X线片示所有患者内固定均牢靠,无软骨下骨骨折。[结论]对于膝关节周围骨巨细胞瘤可以选择病灶扩大刮除、骨水泥充填内固定联合二膦酸盐类药物治疗,该方法具有操作简单、肢体功能恢复理想、近期复发率低、病人易于接受等优点。远期疗效有待进一步观察。
[Objective]To evaluate the feasibility of treating giant cell tumor（GCT） close to the knee with aggressive curettage and cavity filling cementation with internal fixation and oral bisphosphonates.[Method]A retrospective analysis was performed in 16 patients who underwent surgical treatment for giant cell tumor close to the knee from January 2008 to June 2010.There were 7 males and 9 females with mean age of 38 years.All tumors were present around the knee：10 at the distal femur and 6 at the proximal tibia.All patients were carefully assessed before surgery to determine the integrity of the tumor cavity.All patients were treated with aggressive curettage by high-speed burring and cementation with internal fixation.Oral bisphosphonate was given after operation.[Result]The median follow-up of this series was 15 months.All patients continued to be monitored,with none lost to follow-up.No local recurrence or metastasis was observed at the last follow-up.The MSTS score,reflecting the function of the operated limb was a mean 29（rang,27-30）.At the last follow-up,all patients had solid fixation without fracture of the subchondral bone on plain radiographs.[Conclusion]Patients with GCT near the knee joint can be treated satisfactorily with aggressive curettage and cavity filling cementation with internal fixation and oral bisphosphonate.The advantages of the method are safe and effective.Long-term effect needs further observation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第14期1158-1161,共4页
Orthopedic Journal of China
