摘要
[目的]探究骨水泥联合胶原基骨修复材料对比异体骨治疗膝关节周围骨巨细胞瘤的临床效果。[方法]回顾性分析2003年1月1日至2021年12月30日东部战区总医院收治的膝关节周围CampanacciⅡ期骨巨细胞瘤(giant cell tumor of bone,GCT)患者。研究纳入患者68例,股骨下端33例,胫骨上端35例。其中22例行骨水泥联合胶原基骨修复材料手术治疗,46例行异体骨植骨手术治疗。两组患者性别、年龄、肿瘤位置、肿瘤大小以及膝关节功能无统计学差异(P>0.05)。比较两组患者术前一般情况、术后肿瘤复发率、感染率、骨性关节炎发生率、术后末次随访时骨与软组织肿瘤协会(MSTS)评分。[结果]随访时间3~216个月,中位随访时间86个月。异体骨植骨组MSTS平均评分为26.0±4.87,骨水泥联合胶原基骨修复材料组MSTS平均评分为28.5±1.75,术后功能优于异体骨植骨组(P=0.003)。异体骨植骨组术后复发7例,7例发生骨性关节炎,术后感染发生3例。骨水泥联合胶原基骨修复材料组复发1例,6例发生骨性关节炎,术后无发生感染。两组术后复发率具有显著性差异(P=0.026),骨性关节炎及感染发生率无统计学差异(P>0.05)。[结论]骨水泥联合胶原基骨修复材料治疗膝关节周围骨巨细胞瘤具有更好的功能,更低的复发率,且不增加骨性关节炎的发生率等优点,值得临床推广。
[Objective]To compare the clinical effect of collagen bone repair material combined bone cement and allograft bone in the treatment of giant cell tumor of bone around knee joint.[Methods]The clinical data of 68 patients with Campanacci stageⅡgiant cell tumor(GCT)of bone around the knee joint treated from January 2003 to December 2021 were retrospectively analyzed,including 33 tumors located at the distal femur,and 35 at the proximal tibia.Twenty two cases were treated with osteocollagen repair material with bone cement(bone cement group),and 46 cases were treated with allograft bone(allograft group),after the tumor was devitalized and removed with curettage.There was no significant difference in gender,age,tumor size,tumor location and preoperative knee function between two groups.The general preoperative condition,postoperative tumor recurrence rate,infection rate,incidence of osteoarthritis and bone and Soft Tissue Tumor Society(MSTS)score were compared between two groups at the last postoperative follow-up.[Results]Patients were followed up for 3~216months with a median of 86 months.The MSTS score of the allograft group and bone cement group was(26.0±4.87)and(28.5±1.75),respectively(P=0.003).Postoperative recurrence occurred in 6 cases,osteoarthritis occurred in 7 cases,and postoperative infection occurred in 3 cases in the allograft group,while there was 1 case of recurrence,6 cases of osteoarthritis and no postoperative infection in the bone cement group.There was significant difference in recurrence rate between the two groups,but no difference in incidence of osteoarthritis and infection.[Conclusion]The combined treatment of giant cell tumor of bone around knee joint with bone cement and collagen repair material has the advantages of better function and lower recurrence rate without increasing the incidence of osteoarthritis than bone allograft,which is worthy of clinical promotion.
作者
赵子涵
朱岩
刘子赢
王一村
周光新
樊根涛
ZHAO Zi-han;ZHU Yan;LIU Zi-yin;WANG Yi-cun;ZHOU Guang-xin;FAN Gen-tao(Eastern Theater General Hospital,Nanjing 210002,China;Army Medical University,Chongqing 400000,China)
出处
《肿瘤学杂志》
CAS
2022年第9期753-757,共5页
Journal of Chinese Oncology
基金
江苏省卫生健康委科研面上项目(M2020025)。
关键词
骨巨细胞瘤
手术
胶原基骨修复材料
异体骨
giant cell tumor
surgery
collagen bone repair material
allograft bone
