王冀川;孙馨;杨毅;汤小东;郭卫;

• 1:北京大学人民医院骨与软组织肿瘤治疗中心

摘要(Abstract)：

[目的]探讨胫骨近端骨肿瘤切除重建后假体的中长期生存情况和假体失败的原因。[方法]对2001～2013年肿瘤切除、胫骨近端肿瘤型膝关节假体重建或假体翻修的143例患者(165例假体)进行回顾性研究。采用Kaplan-Meier法计算生存曲线及生存率,Log-rank检验行单因素分析,Cox回归进行多因素分析。[结果]所有患者平均随访时间(84.19±47.33)个月。截止最后一次随访,143例患者中,97例无瘤生存,18例带瘤生存,28例死亡,11例截肢。165例假体中,胫骨近端肿瘤型膝关节假体5年生存率80.67%,10年生存率73.82%,其中,国产与进口型假体总生存间差异无统计学意义(P>0.05);假体骨水泥固定与生物固定方式间的生存差异无统计学意义(P>0.05);初治手术假体与翻修手术假体间生存差异无统计学意义(P>0.05);组配型假体与定制型假体生存差异无统计学意义(P>0.05)。根据假体失败的定义标准,共出现假体失败37例。根据ISOLS推荐假体失败类型分类:其中I型失败7例,II型3例,III型3例,IV型14例,V型10例。假体周围感染是最常见导致假体失败的原因,金黄色葡萄球菌为最常见的致病菌。将胫骨近端假体应用设计参数纳入COX多因素分析显示,胫骨侧假体柄长度大于131mm者假体预后较好(P<0.05)。[结论]假体周围感染是导致中期假体失败的最主要原因,应进一步延长随访时间,观察假体远期效果。

关键词(KeyWords)： 骨肿瘤;胫骨近端;肿瘤型膝关节假体;重建术;假体生存;假体失败

Abstract:

Keywords:

基金项目(Foundation): 北京大学人民医院研究与发展基金资助课题(编号:2147000127)

作者(Author): 王冀川;孙馨;杨毅;汤小东;郭卫;

Email:

DOI:

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