摘要
[目的]总结膝关节肿瘤保肢手术不同假体置换的术后比较及评价标准的效能。[方法]86例膝关节肿瘤中,失访9例,余77例中40例采用单纯铰链式假体置换(A组),25例采用旋转铰链式假体置换(B组),12例采用半关节置换(C组)。77例平均随访3年6个月,按Enneking膝关节评分标准(见表1)、ambulation scores(见表2)及感染、复发、转移死亡进行评估。[结果]A组:复发5例,转移死亡3例(均为骨肉瘤),感染2例;B组:复发3例,转移死亡2例(1例为恶性纤维组织细胞瘤,余4例为骨肉瘤),感染1例;C组:复发1例,转移死亡1例(均为骨肉瘤)感染1例。各组无假体松动病例。去除复发及转移死亡病例后,剩62例,A组32例,B组18例,C组10例。A、B组Enneking评分P>0.05,无显著性差异;A、C及B、C组P<0.05,有显著性差异;Ambulation scores各分项及总分均P<0.05,有显著性差异。[结论]各组在术后并发症方面短期未见显著差别,但在术后功能方面Ambulation scores旋转铰链假体置换明显优于单纯铰链式假体置换和半关节置换,而Enneking则没能体现出前两组术后功能方面的显著性差异。因此Ambulation scores更适合对膝关节保肢术后功能评价。
[ Objective] To investigate and compare the effects after resection of tumors round the knees and to discuss the evaluation criteria. [ Method ] Of 86 patients with tumor round the knees, 77 were followed up for an average of 3.5 years. Forty knees in 40 patients underwent total knee replacement using hinge - knee systerm （ group A ）, 25 kness in 25 patients underwent total knee replacement using rotating knee systerm （group B）, and 12 knees underwent semi -replacement in 12 patients （group C） . Assessment was done with Enneking functional scores, ambulation scores, flexion -extension -angle, knee rotation and infection, recurrence, and operative time. [ Result ] In group A, there were 5 cases of recurrence, 3 cases of metastasis/death, and 2 cases of infection. In group B, there were 3 cases of recurrence, 2 cases of metastasis/death , and 2 cases of infection. No prosthesis flexible was in both groups. Apart from the cases of recurrence and metastasis/death, there were 32 cases in group A, 20 cases in group B, and 10 cases in group C. Enneking scores had no significant difference （P 〉 0. 05） between group A and B, but significant difference between A and C or between B and C （ P 〉 0. 05） . Ambulation scores revealed significant difference （P 〈 0. 05） between groups. [ Conclusion ] There were no innediate difference in complications between groups. Ambulation scores showed that rotation knee system is superior to the other two systems. It is more useful to evaluate the function after knee salvage.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第17期1307-1310,共4页
Orthopedic Journal of China
关键词
膝关节
肿瘤
假体
置换
knee joint
tumor
prosthesis
replacement
