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[目的]探讨采用病灶内肿瘤扩大刮除、骨水泥填充并钢板内固定联合二磷酸盐治疗邻膝关节骨巨细胞瘤的临床应用可行性。[方法]回顾分析2008年1月~2010年6月本科治疗的16例邻膝关节骨巨细胞瘤。男7例,女9例,平均年龄38岁(27~78岁)。发病部位:股骨远端10例,胫骨近端6例。所有患者术前均经仔细评估确定肿瘤腔的完整性,术中仔细刮除肿瘤组织,应用磨钻及电刀处理瘤腔壁,骨水泥填充修复骨缺损,同时给予钢板内固定。术后均应用二膦酸盐类药物。[结果]本组患者全部获得随访,中位随访15个月,无局部复发及转移发生。参照Ennek ing肢体功能评分标准,本组患者平均得29分(27~30)分。复查X线片示所有患者内固定均牢靠,无软骨下骨骨折。[结论]对于膝关节周围骨巨细胞瘤可以选择病灶扩大刮除、骨水泥充填内固定联合二膦酸盐类药物治疗,该方法具有操作简单、肢体功能恢复理想、近期复发率低、病人易于接受等优点。远期疗效有待进一步观察。
[Objective] To investigate the feasibility of clinical application of intramedullary giant cell tumor of knee joint by intralesional tumor scaling, bone cement filling and plate fixation with diphosphate. [Methods] A retrospective analysis of 16 cases of giant cell tumor of the knee adjacent to the knee joint treated from January 2008 to June 2010 was conducted. 7 males and 9 females, with an average age of 38 years (27 to 78 years). The incidence of parts: the distal femur in 10 cases, 6 cases of proximal tibia. All patients were carefully assessed before surgery to determine the integrity of the tumor cavity, surgery to carefully scrape the tumor tissue, the use of grinding and electric knife to treat the tumor wall, bone cement fill bone defect repair, while giving plate fixation. After the application of bisphosphonates. [Results] All patients in this group were followed up for a median of 15 months without local recurrence and metastasis. With reference to Ennek ing limb functional rating criteria, patients in this group averaged 29 points (27-30) points. X-ray examination showed that all patients with internal fixation are solid, no subchondral bone fracture. [Conclusion] For the treatment of giant cell tumor of knee joint, we can choose to expand the curettage, bone cement filling and internal fixation combined with bisphosphonates treatment. The method has the advantages of simple operation, satisfactory recovery of limb function, low recurrence rate in recent period and easy patient Accepted and so on. Long-term efficacy needs further observation.