定制旋转铰链型人工膝关节置换治疗膝部骨肿瘤19例
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肿瘤型人工全膝关节假体置换术肿瘤型人工全膝关节假体置换术治疗严重成人股骨远端非骨化性纤维瘤张东四川省内江市第二人民医院骨科,四川内江641000目的探讨肿瘤型膝关节假体置换术治疗成人非骨化性纤维瘤的临床疗效和应用价值。
方法采用膝关节定制型肿瘤假体置换术治疗严重成人股骨远端非骨化性纤维瘤12例,手术均在气管插管全身麻醉下进行,采用仰卧位,行膝关节定制型肿瘤假体置换术。
结果术后12例全部获得随访,随访6~32个月,平均18个月。
疼痛完全消失,活动良好,未出现假体断裂、松动及脱出,无血管、神经损伤等并发症。
结论肿瘤型膝关节假体置换术治疗成人非骨化性纤维瘤,患者疼痛完全消失,可早期下床活动,避免了病理性骨折和植骨融合失败,为一积极有效的方法。
[Abstract] Objective To investigate the clinical effects and application value of tumorous type artificial total knee joint prosthetic replacement in the treatment of severe adult distal femoral non-ossifying fibroma. Methods 12 patients with severe adult distal femoral non-ossifying fibroma received the treatment of knee joint customized tumor prosthetic replacement. All the operations were performed under general anesthesia by tracheal intubation in the supine position with knee joint customized tumor prosthetic replacement. Results All patients received postoperative follow-up for 6 to 32 months, with an average of 18 months. The pain completely disappeared and the motion was good. There was no appearance of prosthesis fracture, loosening and prolapse, and no appearance of blood vessels, nerve damage and other complications. Conclusion Tumorous type artificial total knee joint prosthetic replacement in the treatment of severe adult distal femoral non-ossifying fibroma can relieve the patients′ pain completely, provide early ambulation and prevent pathological fracture and bone graft fusion failure, therefore it is a positive and effective method.[Key words] Non-ossifying fibroma; Pain; Knee joint; Prosthesis非骨化性纤维瘤(non-ossifying fibroma,NOF)是一种少见的纤维组织肿瘤[1]。
旋转铰链膝关节假体的临床应用王振虎;侯利军;李天旺;郭连江;于洋;姚会欣【期刊名称】《河北医科大学学报》【年(卷),期】2015(036)010【摘要】目的观察旋转铰链型膝关节假体治疗复杂膝关节疾病的近期疗效.方法应用旋转铰链型膝关节假体置换治疗严重膝关节畸形及翻修手术患者8例,比较手术前后膝关节活动度及美国特种外科医院膝关节评分(Hospital for Special Surgery Knee Score,HSS),明确其疗效.结果术后患者随访9~24个月,平均(18.0±5.4)个月,畸形矫正,疼痛消失,无1例发生并发症;所有患者行走步态恢复,膝关节活动度和HSS与术前比较均明显改善和增加,差异有统计学意义(P<0.01).结论旋转铰链型膝关节假体治疗复杂膝关节病变及翻修术近期效果良好,远期效果有待进一步观察.【总页数】4页(P1188-1190,封2)【作者】王振虎;侯利军;李天旺;郭连江;于洋;姚会欣【作者单位】中国人民解放军第二五二医院关节外科,河北保定071000;中国人民解放军第二五二医院关节外科,河北保定071000;中国人民解放军第二五二医院关节外科,河北保定071000;中国人民解放军第二五二医院关节外科,河北保定071000;中国人民解放军第二五二医院关节外科,河北保定071000;中国人民解放军第二五二医院关节外科,河北保定071000【正文语种】中文【中图分类】R687.42【相关文献】1.旋转铰链式人工膝关节假体临床应用的初步体会 [J], 郑秋坚;肖丹;刘斌2.旋转铰链型膝关节假体临床应用21例临床分析 [J], 陈祖星;胡世平;徐杰3.旋转铰链膝关节假体在治疗复杂膝关节疾病中的临床应用 [J], 王振虎;高成杰;侯利军;李天旺;陈超4.可旋转铰链膝关节假体治疗夏科氏关节病一例报告 [J],5.旋转铰链型膝关节假体临床应用30例随访观察 [J], 及松洁;李玉军;黄野;周乙雄;张洪;殷建华;周一新因版权原因,仅展示原文概要,查看原文内容请购买。
中国组织工程研究与临床康复 74眷 35 2010—08—27出版 Journal of Clinical Rehabilitative Tissue Engmeeflng Research August 27,2010 VoL 14,No.35
定制旋转铰链型人工膝关节置换治疗膝部骨肿瘤1 9例☆
肖文峰,李康华,雷光华,胡懿邰,廖前德,朱勇,李人杰,龙海涛 Custom・made rotating hinge artificial total knee replacement for the treatment of bone tumors surrounding the knee in 1 9 cases
Xiao Wen—feng,Li Kang-hua,Lei Guang—hua,Hu Yi-he,Liao Qian—de,Zhu Yong,Li Ren-jie.Long Hal—tao
DeparLment of Orthopedics,Xiangya Hospita1.CentraI South University, Changsha 410000, Hunan Province. China
Xiao Wen-feng@, Doctor,Attending physician, Department of Orthopedics.Xiangya Hospita1.CentraI South University, Changsha 410000. Hunan Province, China xiaowf01@ yahoo com cn
Received:2010—04_10 Accepted:2010—06-10
中南大学湘雅医 院骨科,湖南省长 沙市410000
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
中图分类号:R318 文献标识码:B 文章编号1673-8225 (2010p5-06616—04
收稿日期:2010-04—10 修回日期:2010・06—10 f20100410002/GW A)
6616
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 1 9 patients with benignant or malignant bone tumors around the knee,including 1 3 males and 6 females,aged 1 9—51 years.There were 6 cases of benignant tumors,1 3 of malignant tumors, 1 5 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 CONcLus10N: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-+1 35.88)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 Iung metastasis The extension and flexion of knee activity was respectively 0。and 95 140。f124.47-+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.
Xiao WF,Li KH,Lei GH,Hu YH,Liao QD,Zhu Y,Li RJ,Long HT.Custom—made rotating hinge artificial total knee replacement for the treatment of bone tumors surrounding the knee in 1 9 cases.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2010;14(35):6616—6619. 【http://www crter.cn http://en.zglckfcom】
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 f30.45_+21.44)个月, 仅1例局部复发,无肺部转移。膝关节活动范围伸O。,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 doi:10.3969/j issn.1673—8225.2010 35.039
肖文峰,李康华,雷光华,胡懿邰,廖前德,朱勇,李人杰,龙海涛定制旋转铰链型人工膝关节置换治疗膝部骨肿瘤19 例【J】中国组织工程研究与临床康复,2010,14(35):6616-6619. 【http://www.crter.org http://cn.zglckf.corn】
0 引言 作为人体最大的关节,膝关节的功能至关 重要。膝关节功能的缺失会给患者的生活质量 造成严重影响,而膝关节又是骨肿瘤尤其是恶 性骨肿瘤的高发部位。肿瘤对膝关节的破坏采 取何种方法治疗、如何在保证肿瘤治疗效果的 前提下使患者膝关节功能恢复最大化,这些问 题一直以来都在困扰着骨科医师。关节融合和 截肢对于膝关节良恶性骨肿瘤的治疗固然有 效,但肢体功能的丧失显而易见。在新辅助化 疗的协助下,恶性骨肿瘤的保肢治疗也取得了 和截肢治疗同等的效果,5年生存率显著提高。 但保肢治疗肿瘤切除后的重建是一个重要的问 题,关节融合、生物性关节成形、异体骨移植、 灭活再植等方式效果差强人意,人工关节的出 现则提供了新的解决方案,在切除肿瘤的同时 有望获得更好的膝关节功能。 随着有效化疗的广泛开展,肿瘤广泛切除 后人工膝关节置换已经成为膝关节周围骨肿瘤 保肢重建的主要方法。人工关节假体设计与制
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