侵入膝关节腔的恶性肿瘤关节外切除4例临床观察

doi:10.3760/cma.j.issn.2095-7041.2019.01.006

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摘要目的分析恶性肿瘤侵入膝关节腔内的诊断要点,探讨关节外全膝关节切除术的解剖学基础、关键技术及临床疗效。方法回顾性分析2017年6月—2018年2月收治的4例侵入膝关节腔的恶性肿瘤患者的临床资料。男2例、女2例,年龄38~76岁。患者术前均行X线、CT、MR检查及肿瘤穿刺活检。诊断均经病理组织学证实。4例患者均行关节外全膝关节及肿瘤整块切除术,并行肿瘤型假体置换术。手术取前内侧切口,保持股直肌的连续性,冠状位截断髌骨,保留髌韧带,保持关节囊的完整性,自胫骨结节上方截断胫骨,应用组配式肿瘤型假体修复骨缺损。结果患者均顺利完成手术,无术中血管神经损伤;1例切口延迟愈合。随访7~16个月,膝关节功能恢复满意;末次随访时,4例患者膝关节屈曲活动度分别为95°、100°、100°、110°,伸膝延迟分别为5°、10°、10°、5°,骨与软组织肿瘤协会评分分别为53%、77%、80%、83%,股四头肌肌力分别为4级、4级、5级、5级;无肿瘤复发、转移及死亡病例。结论保留部分伸膝装置的关节外全膝关节切除加肿瘤型假体置换术治疗恶性肿瘤侵入膝关节患者,临床疗效满意。

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	徐明
	郑凯
	韩加
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	于秀淳

关键词 ：骨肿瘤, 膝关节, 关节外切除, 假体植入

Key words： Bone neoplasms Knee joint Extra-articular resection Prosthesis implantation

收稿日期: 2018-07-28

通讯作者: 于秀淳, Email: 13969132190@163.com

引用本文:

徐明, 郑凯, 韩加, 鞠晓聪, 于秀淳. 侵入膝关节腔的恶性肿瘤关节外切除4例临床观察[J]. 中华解剖与临床杂志, 2019, 24(1): 28-31.
Xu Ming, Zheng Kai, Han Jia, Ju Xiaocong, Yu Xiuchun. Extra articular resection of malignant tumor in knee joint cavity: clinical observation of 4 cases. Chinese Journal of Anatomy and Clinics, 2019, 24(1): 28-31.

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