肿瘤膝关节假体与大段同种异体骨重建治疗膝关节周围肿瘤疗效对比

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Abstract Objective To explore the surgical indications，clinical effects and complications of tumor type knee joint prosthesis combined with large segment allograft and vascularized fibula reconstruction in the treatment of periarticular tumors of the knee joint.Methods From June 2010 to June 2015，51 cases of periarticular tumor in our center were analyzed retrospectively，including 28 males and 23 females，aged 7~61 years with an average of (17.8±1.2) years.There were 37 cases of osteosarcoma，12 Ewing’s sarcoma，1 case of recurrence of giant cell of bone，1 case of chondrosarcoma grade Ⅱ.31 cases involved the distal femur and 20 cases involved the proximal tibia.There were 33 cases of tumor type knee arthroplasty，20 of which were located in the femur，13 in the tibia，18 in the femur，11 in the femur and 7 in the tibia.Results all 51 patients were followed up for 47~71 months，with an average of (58.0±3.0) months.14 patients (27.5%) died，23 patients (45.1%) had pulmonary metastasis，3 patients (5.9%) had local recurrence，6 patients(11.8%) had postoperative infection，and 5 patients (9.8%) survived without tumor.The mean score of the patients with tumor type knee prosthesis replacement was (24.5±2.1)，and the mean score of the patients with vascularized fibula reconstruction was (26.1±1.7).Conclusion Limb salvage surgery has become the main treatment of malignant tumors around the knee joint.Tumor type knee prosthesis is the main reconstruction method，with the advantages of early weight-bearing，good stability，early complications and so on.The reconstruction of fibula with vascularization combined with massive allograft has certain advantages for the patients whose epiphysis is not obviously involved and whose expected survival time is longer，but there are many postoperative complications，so the indications must be strictly controled.

Key words： bone tumor tumor type knee prosthesis allogeneic bone with vascular pedicled fibula

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	Wang Zhen
	Liu Jijun

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Wang Zhen,Liu Jijun. A Comparative Study on the Therapeutic Effect of Tumor Knee Prosthesis and Large Segment Allogeneic Bone Reconstruction in the Treatment of Tumor Around Knee Joint[J]. sygkzz, 2019, 25(11): 978-981.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2019/V25/I11/978

［1］张小军，王臻，李靖.3 409例骨关节肿瘤与瘤样病变统计分析［J］.中国骨肿瘤骨病，2010，9(3)：189-195.
［2］Collins M，Wilhelm M，Conyers R，et al.Benefits and adverse events in younger versus older patients receiving neoadjuvant chemotherapy for osteosarcoma：findings from a meta-analysis［J］.J Clin Oncol，2013，31 (18)：2303-2312.
［3］Palmerini E，Colangeli M，Nanni C，et al.The role of FDG PET/CT in patients treated with neoadjuvant chemotherapy for localized bone sarcomas［J］.Eur J Nucl Med Mol Imaging，2017，44 (2)：215-223.
［4］杨迪，吴智钢，付军，等.数字骨库辅助异体骨选配在骨肿瘤中的应用及长期疗效观察［J］.实用骨科杂志，2019，25(5)：423-427.
［5］徐明，郑凯，于秀淳，等.肿瘤型膝关节假体置换治疗胫骨近端骨巨细胞瘤多中心回顾性研究［J］.中国骨与关节杂志，2017，6(2)：87-91.
［6］Wunder JS，Leitch K，Griffin AM，et al.Comparison of two methods of reconstruction for primary malignant tumors at the knee：a sequential cohort study［J］.J Surg Oncol，2001，77(2)：89-99.
［7］许良，张志，代婀娜，等.下肢恶性骨肿瘤切除髋膝关节假体置换后软组织重建52例观察［J］.山东医药，2014，54(17)：105-106.
［8］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［J］.中华外科杂志，2007，45(12)：825-828.
［9］Pilge H，Gradl G，von Eisenhart-Rothe R，et al.Incidence and outcome after infection of megaprostheses［J］.Hip Int，2012，(Suppl 8)：S83-90.
［10］Ruggieri P，Mavrogenis AF，Pala E，et al.Long term results of fixedhinge megaprostheses in limb salvage for malignancy ［J］.Knee，2012，19(5)：543-549.
［11］覃澍，董扬.肿瘤型膝关节假体术后并发症214例分析［J］.中国骨与关节杂志，2016，5(2)：109-113.
［12］Abed YY，Beltrami G，Campanacci DA，et al.Biological reconstruction after resection of bone tumours around the knee：long-term follow-up［J］.J Bone Joint Surg(Br)，2009，91(10)：1366-1372.
［13］Capanna R，Bufalini C，Campanacci M.A new technique for reconstructions of large metadiaphyseal bone defects，a combined graft allograft shel plus vascularized fibula［J］.Orthop Traumatol Surg Res，1993，24 (3)：159-177.
［14］Muscolo DL，Ayerza MA，Aponte-Tinao LA，et al.Use of distal femoral osteoarticular allografts in limb salvage surgery.Surgical technique［J］.J Bone Joint Surg (Am)，2016，88( Suppl 1 )：305-321.
［15］Enneking WF，Campanacci DA.Retrieved human allografts：a clinicopathological study［J］.J Bone Joint Surg (Am)，2001，83 (7)：971-986.
［16］黄俊琪，毕文志，韩纲，等.大段同种异体骨单髁置换术治疗膝关节周围骨肿瘤疗效观察［J］.中国修复重建外科杂志，2017，31(8)：908-912.
［17］邓子文，黄东.同种异体骨移植修复骨缺损的应用进展［J］.山东医药，2017，57(32)：98-100.