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Abstract：
OBJECTIVE: The biological reconstruction of the knee with osteoarticular allografts and resection arthrodesis have been reported but there has not yet been a direct comparison between both these procedures. This study aimed to identify the prognostic factors that influence failure of biological reconstruction and compared the results between both procedures.
METHODS: Between 1994 and 2017, we performed 92 limb-sparing procedures using resection arthrodesis (n = 53) and osteoarticular allograft reconstruction (n = 39) for the management of primary bone tumors around the knee. The minimum follow-up time was 2 years in both groups.
RESULTS: The failure rate of reconstruction in the osteoarticular allograft and resection arthrodesis group was 48.7% and 39.6%, respectively (p = 0.75). The mean MSTS score in the osteoarticular allograft and resection arthrodesis group was 23.7 and 21.8, respectively (p = 0.01). The significant risk factor for failure after biological reconstruction was the administration of chemotherapy (p = 0.001; HR = 3.39; 95% CI, 1.60-7.17).
CONCLUSIONS: Patients who underwent osteoarticular allograft had a better functional outcome than those who underwent resection arthrodesis reconstruction, but clinical outcomes between the groups were comparable. Chemotherapy is a significant adverse prognostic factor for failure of biological reconstruction.
METHODS: Between 1994 and 2017, we performed 92 limb-sparing procedures using resection arthrodesis (n = 53) and osteoarticular allograft reconstruction (n = 39) for the management of primary bone tumors around the knee. The minimum follow-up time was 2 years in both groups.
RESULTS: The failure rate of reconstruction in the osteoarticular allograft and resection arthrodesis group was 48.7% and 39.6%, respectively (p = 0.75). The mean MSTS score in the osteoarticular allograft and resection arthrodesis group was 23.7 and 21.8, respectively (p = 0.01). The significant risk factor for failure after biological reconstruction was the administration of chemotherapy (p = 0.001; HR = 3.39; 95% CI, 1.60-7.17).
CONCLUSIONS: Patients who underwent osteoarticular allograft had a better functional outcome than those who underwent resection arthrodesis reconstruction, but clinical outcomes between the groups were comparable. Chemotherapy is a significant adverse prognostic factor for failure of biological reconstruction.
摘要：
目的：已经报道了骨关节同种异体移植和切除关节固定术对膝关节的生物学重建，但这两种手术之间还没有直接比较。本研究旨在确定影响生物重建失败的预后因素，并比较两种方法之间的结果。
方法：在1994年至2017年之间，我们进行了92例保留肢体的手术，使用切除关节固定术（n=53）和同种异体骨关节重建（n=39）治疗膝关节周围原发性骨肿瘤。两组患者最短随访时间均为2年。
结果：同种异体骨关节移植和切除关节固定术组重建失败率分别为48.7%和39.6%，分别(p=0.75)。同种异体骨关节移植和切除关节固定术组的平均MSTS评分分别为23.7和21.8（p=0.01）。生物重建后失败的重要危险因素是化疗（p=0.001；HR=3.39；95％CI，1.60-7.17）。
结论：接受同种异体骨关节移植的患者比接受切除关节固定术重建的患者有更好的功能结果，但两组间的临床结局具有可比性.化疗是生物重建失败的重要不良预后因素。
方法：在1994年至2017年之间，我们进行了92例保留肢体的手术，使用切除关节固定术（n=53）和同种异体骨关节重建（n=39）治疗膝关节周围原发性骨肿瘤。两组患者最短随访时间均为2年。
结果：同种异体骨关节移植和切除关节固定术组重建失败率分别为48.7%和39.6%，分别(p=0.75)。同种异体骨关节移植和切除关节固定术组的平均MSTS评分分别为23.7和21.8（p=0.01）。生物重建后失败的重要危险因素是化疗（p=0.001；HR=3.39；95％CI，1.60-7.17）。
结论：接受同种异体骨关节移植的患者比接受切除关节固定术重建的患者有更好的功能结果，但两组间的临床结局具有可比性.化疗是生物重建失败的重要不良预后因素。
