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目的探讨持续被动活动(CPM)在微波诱导高温原位灭活保肢手术治疗膝关节周围恶性或侵袭性骨肿瘤术后关节功能康复中的意义。方法微波诱导高温原位灭活保肢手术治疗膝关节周围恶性或侵袭性骨肿瘤,灭活处骨缺损应用脱钙骨基质颗粒加骨水泥修复,局部用钢板或异体皮质骨板内固定,不用外固定。将75例患者随机分为A、B两组。A组40例,术后24h开始使用CP对患肢进行持续被动功能锻炼,连续3周。B组35例术后进行常规功能锻炼。结果75例均获随访,平均随访时间13个月,骨缺损处无骨折和骨不连,内固定良好。至3个月时,A组膝关节活动度110°～160°,平均141°,B组膝关节活动度90°～140°,平均126°,统计学差异有显著性意义,P<0.01。结论微波诱导高温原位灭活治疗膝关节周围骨肿瘤保肢手术,能最大程度地保留膝关节功能术后CPM能进一步改善膝关节的活动度。
Objective To investigate the significance of continuous passive activity (CPM) in the functional rehabilitation of malignant or invasive bone tumors around the knee joint after microwave-induced in-situ high temperature inactivation of limb salvage surgery. Methods Microwave-induced limb salvage in situ in the treatment of malignant or invasive bone tumors around the knee, inactivation of bone defects using decalcified bone matrix particles plus bone cement repair, local use of plate or allogeneic cortical plate fixation, without External fixation. 75 patients were randomly divided into A, B two groups. A group of 40 cases, 24 hours after the start of the use of CP on the limb continuous passive functional exercise for 3 weeks. 35 cases in group B received routine functional exercise after operation. Results All 75 patients were followed up for an average of 13 months. There was no fracture or nonunion in the bone defect, and the internal fixation was good. At 3 months, the activities of knee joint in group A were 110 ° ~ 160 ° with an average of 141 °. The knee joint activity in group B was 90 ° ~ 140 ° with an average of 126 °. The difference was statistically significant (P <0.01). Conclusion The high temperature in-situ microwave inactivation treatment of limb salvage surgery in patients with bone salvage surgery can maximize the retention of knee function CPM can further improve the activity of the knee.