Treatment of malignant bone tumor in knee region by excision and replacement with bone graft: A clinical long-term follow-up study.

概要

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Eight patients with malignant bone tumor arising in knee region treated bymeans of bone graft were followed up for 25 months to 5 years. All of these patients are aliveand well. Most of the reconstructive procedures included a segmental bone allograft with knee fusion. They also had intensive adjuvant chemotherapy for a year. The drugs used were Adriamycin and high dose methotrexate. A local recurrence and a infection required amputations. Then 6 cases were followed up. There were three allograft resorptions which were successfully treated by additional autologous bone grafts. Other complications were a aseptic fistula formation and a fracture of a Kuntcher's nail due to nonunion. Bone healing of the grafts was evaluated on X-ray. All of the primary segmental allograft after the wide resection of the tumor failed in bone healing. Additional autologous bone graft led to the healing in a year. Functional evaluation (by Enneking) showed good in five fused patients and excellent in a hemiresected patient. Reconstructive surgery with massive bone grafts represents a successful alternative to prosthetic implant in young adults with a long life expectancy.
西日本整形・災害外科学会の論文