摘要
目的 :研究大段冷冻异体骨和人工关节复合物修复股骨下段肿瘤切除后骨缺损的疗效。方法 :按Enneking分期 ,广泛性边缘切除股骨下段肿瘤 ,选用长柄人工轴心铰链膝关节将大小和形态合适的同种异体骨关节与宿主骨经骨水泥髓内固定 ,假体柄插入宿主骨髓内长度与异体骨轴心长度比≥ 0 8～ 1。结果 :本组 14例中 ,12例平均随访 3 4个月。 2例分别于术后 9和 15个月死亡。所有患者均无关节脱位、假体松动和断裂。异体骨和宿主骨间均达骨性愈合 ,平均愈合时间 7 4月。术后患侧膝关节平均活动度为 82°。结论 :人工关节通过现代骨水泥固定技术将异体骨与宿主骨有机地连接在一起 ,从而达到牢固的髓内固定。异体骨与宿主骨间的生物性连接 ,增加了人工关节的固定臂 ,从而防止了肿瘤人工关节下沉、松动或断裂等并发症 ,具有异体骨和人工关节两者的优点。
Objective:To analyze the effect of reconstruction for the distal femoral defect by a composite of massive frozen allograft and prosthesis replacement.Methods:According to Enneking's classification,malignant bone tumors of the distal femur were widely resected in 14 cases.Reconstruction of the knee after major joint removal was done by a composite of allograft and prosthesis.A conventional femoral component with a stem long enough to provid good fixation in the femoral shaft was threaded over a customized allograft.After the assembly had been reduced and checked for size and position,the allograft was cemented to the femoral component and the composite was in turn cemented into the femoral shaft with PMMA.Results:Twelve patients were followed up for an average of 34 months,2 cases died respectively in 9 and 15 months.All patients had no dislocation,loosening or breakage of prosthesis.The time of bone healing between allograft and host femur was an average of 7.4 months and the rate of bone healing was 100%.Twelve with total knee composite replacement had degrees of 82°(rangs 68°to 104°).Conclusion:The clinical results demonstrates that the composite of massive frozen allograft and prosthesis replacement have the advantages of both allograft and prosthesis.
出处
《中国矫形外科杂志》
CAS
CSCD
2003年第16期1087-1089,共3页
Orthopedic Journal of China
