儿童膝关节周围骨肉瘤保留骨骺生物重建的近期随访

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (2063 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To evaluate the effectiveness of biological reconstruction in five children of periarticular osteosarcoma of the knee.Methods Five patients with osteosarcoma around knee joint undergoing epiphyseal preserving biological reconstruction in Department of Bone and Soft Tissue of Affiliated Tumor Hospital of Xinjiang Medical University from January 2019 to September 2020 were selected retrospectively.The patents aged (11.6±2.6)years (8～14 years)，including two femurs and three tibias.The length of bone defect was (18.0±6.9)cm (range 12～30 cm).Two femur tumors were treated with inactivated autologous bone by liquid nitrogen with vascularized fibula transplantation.Two tibia tumors were treated with inactivation autologous bone by liquid nitrogen with ipsilateral vascularized fibula transplantation.One tibia tumor was treated with inactivation autologous bone by liquid nitrogen with contralateral vascularized fibula transplantation.Patients regularly underwent X-rays exam to determine the bone healing.Lower limb length and knee flexion and extension function were evaluated at the end of follow-up.Results The patients were followed up for 15～36 months.All cases achieved bone healing，and bone healing time was (5.2±1.9)months (3 ～8 months).Two patients had equal length of limbs，two patients had limb shortening less or equal to 1 cm，and one case had shortening of 2cm.The knee flexion was more than 90°in four patients and 50°～ 60 ° in one patient.No tumor recurrence and distant metastasis.The muscle and skeletal tumor society(MSTS) score was (24.2±2.5)score (range 20～26 score).Conclusion Autogenous bone inactivation by liquid nitrogen with epiphyseal preservation combined with vascularized fibula in reconstruction for osteosarcoma around the knee in children is good to bone healing，limb length maintenance and postoperative functional recovery.The short-term effect is satisfactory.

Key words： osteosarcoma epiphysis autogenous bone liquid nitrogen inactivation vascularized fibula biological reconstruction

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Dai zhibing
	Sun Yachao
	Maierdanjiang·Maihemuti
	Jiang Renbing *

Cite this article:

Dai zhibing,Sun Yachao,Maierdanjiang·Maihemuti, et al. Recent Follow-up of Biological Reconstruction of Epiphysis Preserving Osteosarcoma Around the Knee in Children[J]. sygkzz, 2022, 28(6): 503-508.

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I6/503

［1］Hanna SA，Sewell MD，Aston WJ，et al.Femoral diaphyseal endoprosthetic reconstruction after segmental resection of primary bone tumours［J］.J Bone Joint Surg (Br)，2010，92(6)：867-874.
［2］Han G，Bi WZ，Xu M，et al.Amputation versus limb-salvage surgery in patients with osteosarcoma：a meta-analysis［J］.World J Surg，2016(40)：2016-2027.
［3］Dominkus M，Krepler P，Schwameis E，et al.Growth prediction in extendable tumor prostheses in children［J］.Clin Orthop Relat Res，2001(390)：212-220.
［4］Neel MD，Heck R，Britton L，et al.Use of a smooth press fit stem preserves physeal growth after tumor resection［J］.Clin Orthop Relat Res，2004(426)：125-128.
［5］San-Julian M，Aquerreta JD，Benito A，et al.Indicationgs for epiphyseal preservation in metphyseal malignant bone tumors of children：Relationship between image methods and histological findings［J］.J Pediatr Orthop，1999，19(4)：543-548.
［6］郭卫，王现海，李大森，等.肿瘤型人工膝关节置换治疗膝关节骨肉瘤疗效及并发症分析.中华外科杂志，2007，45(12)：825-828.
［7］Campanacci L，Manfrini M，Colangeli M，etal.Long-term results in children with massive bone osteoarticular allografts of the knee for high-gradeosteosarcoma［J］.J Pediatrorthop，2010，30(8)：919-927.
［8］TsuchiyaH，TomitaK，MinematsuK，et al.Limb salvage using distraction osteogenesis.A classification of the technique［J］.J Bone Joint Surg(Br)，1997，79(3)：403-411.
［9］Assal M，Stern R.The Masquelet procedure gone away［J］.Orthop，2014，37(11)：e1045-e1048.
［10］Pelissier P，Masquelet AC，Bareille R，et al.Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration［J］.J Orthop Res，2004，22(1)：73-79.
［11］Viateau V，Guillemin G，Calando Y，et al.Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects：an ovine model［J］.Vet Surg，2006，35(5)：445-452.
［12］Pelissier P，Lefevre Y，Demond S，et al.Inflfluences of induced membranes on heterotopic bone formation within an osteoinductive complex.Experimental study in rabbits［J］.An Chir Plast Esth，2009，54(1)：16-20.
［13］Zwetyenga N，Catros S，Emparanza A，et al.Mandibular reconstruction using induced membranes with autologous cancellous bone graft and HA-betaTCP：animal model study and preliminary results in patients［J］.Int J Oral Maxillofac Surg 2009，38(12)：1289-1297.
［14］Morelli I，Drago L，George D，et al.Masquelet technique：Myth or reality?A systematic review and meta-analysis［J］.Injury，2016，47(Suppl 6)：68-76.
［15］丁易，牛晓辉，刘巍峰，等.酒精灭活再植术在骨肿瘤治疗中的应用.中华骨科杂志，2011，31(6)：652-657.
［16］Tsuchiya H，Wan SL，Sakayama K，et al.Reconstruction using an autograft containing tumour treated by liquid nitrogen［J］.J Bone Joint Surg(Br)，2005，87(2)：218-225.
［17］Li Y，Yang Y，Huang Z，et al.Bone defect reconstruction with autologous bone inactivated with liquid nitrogen after resection of primary limb malignant tumors：An observational study［J］.Medicine (Baltimore)，2020，99(24)：e20442.
［18］牛晓辉，郝林，张清，等.冷冻异体骨移植治疗骨肿瘤切除后骨缺损［J］.中华外科杂志，2007，45(10)：677-680.
［19］Ikuta K，Nishida Y，Sugiura H，et al.Predictors of complications in heat-treated autograft reconstruction after intercalary resection for malignant musculoskeletal tumors of the extremity［J］.J Surg Oncol，2018，177(7)：1469-1478.
［20］Igarashi K，Yamamoto N，Shirai T，et al.The long-term outcome following the use of frozen autograft treated with liquid nitrogen in the management of bone and soft-tissue sarcomas［J］.Bone Joint J，2014，96B(4)：555-561.
［21］Sorger JI，Hornicek FJ，Zavatta M，et al.Allograft fractures revisited［J］.Clin Orthop Relat Res，2001(382)：66-74.
［22］Takata M，Sugimoto N，Yamamoto N，et al.Activity of bone morphogenetic protein-7 after treatment at various temperatures：freezing vs.pasteurization vs.Allograft［J］.Cryobiology 2011，63(3)：235-239.
［23］Miwa S，Takeuchi A，Shirai T，et al.Outcomes and complications of reconstruction using tumor-bearing frozen autografts in patients with metastatic bone tumors［J］.Anticancer Res 2014，34(10)：5569-5577.
［24］Capanna R，Campanacci DA，Belot N，et al.A new reconstructive technique for intercalary defects of long bones：the association of massive allograft with vascularized fibular autogr；aft.Long-term results and comparison with alternative techniques［J］.Orthop Clin North Am，2007，38(1)：51-60.
［25］Noguchi M，Mizobuchi H，Kawasaki M，et al.An intramedullary free vascularized fibular graft combined with pasteurized autologous bone graft in leg reconstruction for patients with osteosarcoma［J］.J Reconstr Microsurg，2008，24(7)：525-530.
［26］Ozaki T，Fujiwara K，Kunisada T，et al.Reconstruction with ipsilateral fibula transfer with pasteurized bone after excision of bone sarcoma of the tibia［J］.Sarcoma 2004，8(2-3)：97-102.
［27］Soucacos PN，Korompilias AV，Vekris MD，et al.The free vascularized fibular graft for bridging large skeletal defects of the upper extremity［J］.Microsurgery，2011，31(3)：190-197.
［28］Manfrini M，Gasbarrini A，Malaguti C，et al.Intraepiphyseal resection of the proximal tibia and its impact on lower limb growth.［J］.Clin Orthop Relat Res，1999(358)：111-119.
［29］Aponte-Tinao L，Farfalli GL，Ritacco LE，et al.Intercalary femur allografts are an acceptable alternative after tumor resection［J］.Clin Orthop Relat Res，2012(470)：728-734.
［30］Muscolo DL，Ayerza MA，Aponte-Tinao L，et al.Intercalary femur and tibia segmental allografts provide an acceptable alternative in reconstructing tumor resections［J］.Clin Orthop Relat Res，2004(426)：97-102.
［31］Krieg AH，Davidson AW，Stalley PD.Intercalary femoral reconstruction with extracorporeal irradiated autogenous bone graft in limb-salvage surgery［J］.J Bone Joint Surg(Br)，2007，89(3)：366-371.