膝关节周围骨肉瘤保肢手术疗效及预后分析

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Abstract Objective To investigate the clinical efficacy，limb function，survival and complication of patients treated limb-salvage surgery for osteosarcoma around the knee. Methods We retrospectively reviewed the clinical data for 120 patients with osteosarcoma around the knee who treated with limb-salvage surgery between1998 to 2008.The sample included 75 males and 45 females.The mean age of the patients was 18.9 years，ranged from 5 to 48 years.Osteosarcoma was diagnosed in the distal femur in 78 patients and in the proximal tibia in 42 patients.85 patients received standard chemotherapy，while 35 patients received non-standard chemotherapy.Statistical analyses were conducted to process and record patient data and analyze the surgery's efficacy，prognosis and survival rates.Results All patients were followed for 6 to 144 months，with a mean length of 56.8 months.Twelve of the 120 patients (10％) required secondary amputation.The 5-year overall survival rate for the 120 patients was 61.8％.The 5-years overall survival rates were 71.6％ for patients treated with standard chemotherapy and 40％ for those treated with non-standard chemotherapy.There was a significant difference in survival rates between the treatments (P＜0.01).The average MSTS score was 25.47 points.There was no significant difference in postoperative knee flexion between patients with tumor in the distal femur and tumor in the proximal tibia.However，there was a higher incidence of extensor lag in patients with tumor in the proximal tibia than those with tumor in the distal femur，and the difference was significant (P＝0.03).Conclusion Currently，limb-salvage surgery combined with neoadjuvant chemotherapy is the option for treating osteosarcoma around the knee.It can preserve knee function and appearance well，but has a relatively high incidence of complications.

Key words： osteosarcoma limb-salvage surgery distal femur proximal tibia complication survival

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