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目的比较胫骨近端肿瘤假体置换术后不同方法重建伸膝装置的疗效。方法回顾性分析2012年1月至2014年1月,在我院行胫骨近端肿瘤扩大切除、人工假体置换、伸膝装置重建术的患者,评估术后膝关节功能和并发症情况。检索Pub Med,Springer,Ovid,LWW,EMBASE数据库,关键词为胫骨、肿瘤、关节成形术。将相关文献纳入一并讨论。结果本组伸膝装置重建患者32例,均采用假体重建方式。术后随访中出现伸膝迟滞5例,感染2例。共检索到9篇文献,其中骨肉瘤362例,软骨肉瘤26例,尤文肉瘤21例,骨巨细胞瘤21例,软组织肉瘤25例。经典假体重建272例,自体移植物重建2例,生物重建24例。所有膝关节重建术后发生伸膝迟滞29例、感染39例、韧带断裂24例、肿瘤复发25例、假体重建失败133例。结论伸膝装置重建能有效恢复患者膝关节功能,但术后存在并发症较多。比较不同重建方式,没有哪一种技术表现出明显的优越所在。现今手术更趋于生物性重建来改善功能。
Objective To compare the curative effect of different methods of reconstruction knee extensor device after replacement of proximal tibial tumor prosthesis. Methods From January 2012 to January 2014, we retrospectively analyzed the patients with postoperative tibial tumor resection, artificial prosthesis replacement and extensor knee reconstruction in our hospital from January 2012 to January 2014 to evaluate the postoperative knee joint function and complications. PubMed, Springer, Ovid, LWW, and EMBASE databases were searched for the keywords tibia, tumor, and arthroplasty. Relevant documents will be included in the discussion. Results In this group, 32 patients were reconstructed with knee extensor devices, and prosthesis reconstruction was used. Postoperative follow-up appeared in 5 cases of knee extensor lag, infection in 2 cases. A total of 9 articles were retrieved, including 362 cases of osteosarcoma, 26 cases of chondrosarcoma, 21 cases of Ewing’s sarcoma, 21 cases of giant cell tumor of bone and 25 cases of soft tissue sarcoma. There were 272 cases of classic prosthesis reconstruction, 2 cases of autograft reconstruction and 24 cases of biological reconstruction. All knees delayed hysterectomy occurred in 29 cases of knee extension, infection in 39 cases, 24 cases of ligament rupture, tumor recurrence in 25 cases, prosthesis failed to reconstruct 133 cases. Conclusion The extensor knee reconstruction can effectively restore the knee joint function, but there are more postoperative complications. Compared to different reconstruction methods, no one technology shows obvious superiority. Surgery is now more biologically reconstructed to improve function.