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体内刮除及灭活植骨治疗膝部巨细胞瘤(GCT)的复发率高。作者自1991年1月采用瘤体骨切除,离体灭活再植,与骨残端体内灭活相结合。骨缺损采用自家腓、髂骨移植,L-梯形加压钢板(L-TCP)或梯形加压钢板(TCP)固定、治疗膝部GCT 13例,其中8例保留关节,5例做膝关节融合。本组无菌创口感染1例,1例复发恶变做截肢。在保留关节的8例中7例关节功能恢复优良,1例差。表术式疗效确实,复发率低。保留关节术式适于关节破坏较轻(≤1/2)者,结舍关节残端体内灭活和有效的骨结构重建,有利恢复关节功能。如关节面累及>1/2,宜做骨关节端切除,灭活再植,关节融合或人工关节置换术。
In vivo curettage and inactivation of bone grafts have a high recurrence rate for giant cell tumor of the knee (GCT). Since January 1991, the authors used tumor bone resection, in vitro replantation, combined with in vivo inactivation of bone stumps. The bone defect was treated with its own tendon and iliac bone graft, L-TCP trapezoidal compression plate (TCP), and 13 cases of knee GCT were treated. Among them, 8 cases retained joints, and 5 cases performed knee fusion. . In this group, 1 case was infected with a sterile wound, and 1 case was relapsed and treated as an amputation. Among the 8 cases of preserved joints, 7 cases had excellent joint function recovery and 1 case was poor. The efficacy of table treatment is indeed low and the recurrence rate is low. The reserved arthroscopic surgery is suitable for those with less joint damage (≤1/2), in vivo inactivation of the joint stump, and effective bone structure reconstruction, which is beneficial for restoring joint function. If the articular surface involves more than 1/2, bone and joint end resection, inactivation replantation, joint fusion or artificial joint replacement should be performed.