中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (35): 6616-6619.doi: 10.3969/j.issn.1673-8225.2010.35.039

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

定制旋转铰链型人工膝关节置换治疗膝部骨肿瘤19例

肖文峰，李康华，雷光华，胡懿郃，廖前德，朱  勇，李人杰，龙海涛   

  1. 中南大学湘雅医院骨科，湖南省长沙市  410000
  • 出版日期:2010-08-27 发布日期:2010-08-27
  • 作者简介:肖文峰☆，男，1979年生，湖南省耒阳市人，汉族，2008年中南大学湘雅医院毕业，博士，主治医师，主要从事关节外科研究。 xiaowf01@yahoo.com.cn

Custom-made rotating hinge artificial total knee replacement for the treatment of bone tumors surrounding the knee in 19 cases

Xiao Wen-feng, Li Kang-hua, Lei Guang-hua, Hu Yi-he, Liao Qian-de, Zhu Yong, Li Ren-jie, Long Hai-tao   

  1. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha  410000, Hunan Province, China
  • Online:2010-08-27 Published:2010-08-27
  • About author:Xiao Wen-feng☆, Doctor, Attending physician, Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China xiaowf01@yahoo.com.cn

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342

被引次数

3

摘要：

背景：早期的固定铰链式关节由于存在较高的假体翻修率，已逐渐被旋转铰链式人工关节所替代。定制型人工膝关节还可以更好的匹配患者的解剖形态，实现机械和解剖的多样性个体化。
目的：评估定制旋转铰链型人工膝关节置换治疗膝部良恶性骨肿瘤的临床效果。
方法：应用旋转铰链型人工膝关节置换治疗膝部骨肿瘤患者19例，男13例,女6例,年龄19~51岁；其中良性骨肿瘤6例，恶性骨肿瘤13例，股骨下端肿瘤15例，胫骨上端肿瘤4例。 采用Enneking功能评定标准评估术后功能，复查X射线片评估假体情况与肿瘤复发。
结果与结论：手术时间 2.5~5.3(3.64±0.89) h，术中出血量300~800(452.63±135.88) mL。19例均获随访，随访时间3~64 (30.45±21.44)个月， 仅1例局部复发，无肺部转移。膝关节活动范围伸0°，屈曲95°~140°(124.47±12.89)°，Enneking功能评分为(20.95±3.69)分，优良率为89%。结果说明定制旋转铰链型人工膝关节置换是一种有效的治疗膝部良恶性骨肿瘤的保肢方法。

关键词: 膝关节, 骨肿瘤, 化疗, 关节置换, 保肢治疗, 重建, 人工假体

Abstract:

BACKGROUND: The former fixed-hinge design artificial knees have been gradually replaced by rotating-hinge artificial knees due to the high risk of revision. The custom-made rotating hinge artificial total knee can better match the patients’ anatomy and achieve mechanical multiformity and individualized anatomy.
OBJECTIVE: To investigate the clinical effects of custom-made rotating hinge artificial total knee replacement for benignant or malignant bone tumors around the knee.
METHODS: Rotating hinge prosthesis replacement was performed in 19 patients with benignant or malignant bone tumors around the knee, including 13 males and 6 females, aged 19-51 years. There were 6 cases of benignant tumors, 13 of malignant tumors, 15 cases involving distal femur and 4 cases in proximal tibia. Enneking Functional Score was used to evaluate the post-operation functions. Radiographs were shot on the postoperative visit to evaluate the prosthesis conditions and tumor relapse.
RESULTS AND CONCLUSION: The average operating time was (3.64±0.89) hours (range 2.5-5.3 hours) and the average intraoperative blood loss was (452.63±135.88) mL (range 300-800 mL). All the patients were followed-up with an average time of (30.45±21.44) months (range 3-64 months). Local relapse was observed in one patient, and one survived with the presence of lung metastasis. The extension and flexion of knee activity was respectively 0° and 95°-140° (124.47±12.89)°. The excellent and good rate was 89%. Custom-made rotating hinge artificial total knee replacement is an efficacious limb salvage method for the treatment of benignant or malignant bone tumors around the knee.

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