摘要
为观察半关节假体置换用于儿童膝关节周围骨肉瘤的效果。于1998-10/2006-07对15例膝关节周围骨肉瘤患儿行瘤段切除并半膝关节假体置换。影像学提示瘤灶位于股骨远端9例,胫骨近端6例,病变范围9～11cm。术前经病理检查确诊为骨肉瘤。按Enneking分期,均在Ⅱa期。术前均行一两个疗程的化疗。术前根据X射线平片、CT或MRI测量设计匹配的假体,假体略长于截骨段1.0～2.0cm。髌韧带及侧副韧带重建于人工半膝关节假体上。15例患儿均成功完成半膝关节假体置换。随访2～6年,患儿身高增加了4～6cm,患肢短缩1～3cm,均能进行日常生活学习。按Enneking肢体肌肉骨骼肿瘤外科治疗重建膝关节置换后功能评估:优7例,良5例,中2例,差1例。说明将半关节假体应用于儿童膝关节周围骨肉瘤的治疗,具有重建膝关节功能,保留正常端骨骺,最大限度减少膝关节置换后患肢缩短,并为成年后行全关节置换创造了条件。
To investigate the effect of semi-joint prosthesis replacement in treating osteosarcoma around the knee joint, 15 children with osteosarcoma around the knee joint underwent semi-joint prostheses replacement and removal of the section with tumor from October 1998 to July 2006. Imageology showed that tumor of 9 children was located at the distal femur, and 6 cases at the proximal tibia. The pathologic changes involved the upper segment of the tibia 9 11 cm in length. All the children had been diagnosed with osteosarcoma by pathological examination, which was graded as stage II a according to Enneking staging system. All the patients underwent neoadjuvant chemotherapy preoperatively for 1 2 courses. The size of prosthesis was determined based on preoperative X-ray, CT and MRI. The length of the prosthesis should be 1.0-2.0 cm longer than that of the excised bone. Patellar and collateral ligaments were reconstructed in the artificial semi-knee joint prosthesis. All the 15 patients had a successful semi-joint prosthesis replacement. During the follow-up of 2 to 6 years, body height of the children increases by 4-6 cm, and the affected limbs shortened 1-3 cm. All children could live and study normally. There were 7 excellent, 5 good, 2 fine and I poor according to Enneking evaluation system. The semi-joint prosthesis replacement in the limb salvage surgery for child osteosarcoma around the knee joint can reconstruct knee joint function, remain normal osteoepiphysis, minimize affected limb crispation after operation, and create the condition for total knee replacement in adults.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第48期9519-9522,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
