膝关节肿瘤假体与骨结合部皮质外骨桥的影像学观察Radiographical observation of the extracortical bone bridge around the shoulder of custom-made knee tumor prosthesis
卢群山;李建民;杨强;杨志平;李振峰;
摘要(Abstract):
[目的]通过影像学观察膝关节肿瘤假体与骨结合部皮质外骨桥的形成情况。[方法]33例膝关节周围肿瘤患者行瘤段骨切除、定制型假体置换术,其中20例植骨,13例未植骨。影像学观察皮质外骨桥的形成情况,评估患者术后肢体功能。[结果]平均随访26个月。所有20例植骨者均有骨桥形成,未植骨者10例有骨桥形成、3例无骨桥形成;25例存在皮质外骨桥下透亮线。按Enneking骨骼肌肉肿瘤术后下肢功能评分标准,33例患者平均功能恢复率为74.3%;[结论]植骨有利于皮质外骨桥生长,皮质外骨桥偏向性生长与局部压应力相适应;透亮线的存在说明目前的假体设计技术可能达不到骨长入性生长。
关键词(KeyWords): 骨肿瘤;定制型肿瘤假体;皮质外骨桥;长入性生长
基金项目(Foundation):
作者(Author): 卢群山;李建民;杨强;杨志平;李振峰;
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DOI:
参考文献(References):
- [1]Chao EY.A composite fixation principle for modular segmental defect replacement(SDR)prostheses[J].Orthop Clin North Am,1989,3:439-453.
- [2]杨强,李建民,杨志平,等.骨肉瘤髓腔内侵袭范围MRI测量与确定合理截骨平面的相关研究[J].中国矫形外科杂志,2005,23:1792-1794.
- [3]Unwin PS,Cannon SR,Grimer RJ,et al.Aseptic loosening in cemen-ted custom-made prosthetic replacements for bone tumours of the lower limb[J].J Bone Joint Surg Br,1996,1:5-13.
- [4]Griffin AM,Parsons JA,Davis AM,et al.Uncemented tumor endopros-theses at the knee:root causes of failure[J].Clin Orthop Relat Res,2005,438:71-79.
- [5]Flint MN,Griffin AM,Bell RS,et al.Aseptic loosening is uncommon with uncemented proximal tibia tumor prostheses[J].Clin Orthop Re-lat Res,2006,450:52-59.
- [6]陈继营,王岩,卢世璧,等.皮质外骨桥固定特制假体置换治疗肢体骨肿瘤[J].中国矫形外科杂志,2005,9:1301-1303.
- [7]Virolainen P,Inoue N,Nagao M,et al.Autogenous onlay grafting for enhancement of extracortical tissue formation over porous-coated seg-mental replacement prostheses[J].J Bone Joint Surg Am,1999,4:493-499.
- [8]Fukuroku J,Inoue N,Rafiee B,et al.Extracortical bone-bridging fixation with use of cortical allograft and recombinant human osteogen-ic protein-1[J].J Bone Joint Surg Am,2007,7:1486-1496.
- [9]Virolainen P,Inoue N,Nagao M,et al.The effect of multidrug chem-otherapy on bone graft augmented prosthesis fixation[J].J Orthop Res,2005,4:795-801.
- [10]Kaste SC,Neel MD,Meyer WH,et al.Extracortical bridging callus after limb salvage surgery about the knee[J].Clin Orthop Relat Res,199,363:180-185.
- [11]Tanzer R,Turcotte E,Harvey J,et al.Extracortical bone bridging in tumor endoprostheses.Radiographic and histologic analysis[J].J Bone Joint Surg Am,2003,12:2365-2370.