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Abstract：
BACKGROUND: The inactivation and replantation of autologous tumor bones are important surgical methods for limb salvage in patients with malignancies. Currently, there are few reports on the inactivation and replantation of the knee joint. In this study, we aimed to evaluate the feasibility of our surgical approach.
METHODS: This is a retrospective case series study. We retrospectively collected the clinical data of patients with sarcoma treated with knee joint inactivation and replantation and analyzed the efficacy of this surgical method. The bone healing and complications in these patients after inactivated autograft replantation were assessed.
RESULTS: This study included 16 patients. Fifteen patients had osteosarcoma, and one had Ewing\'s sarcoma. The average length of the inactivated bone is 20.2 cm (range 13.5-25.3 cm). All the patients underwent internal plate fixation. The average follow-up duration was 30 months (range 8-60 months). Before the data deadline of this study, eight (50%) patients were still alive, and eight (50%) died of sarcoma metastasis. Eight (50%) patients achieved bone healing at the diaphysis site of the inactivated tumor bone, with an average bone healing time of 21.9 months (range, 12-36 months). Five (31%) patients died due to metastases and did not achieve bone healing. Two (12.5%) patients did not achieve bone healing because of infection, and one (6.3%) patient underwent amputation due to tumor recurrence. Ten (62.5%) patients experienced fractures around the joint ends of the inactivated replanted bone, and eight of these ten patients were combined with joint dislocation.
CONCLUSIONS: The incidence of joint deformities after the knee-joint inactivation and replantation is extremely high and is not recommended for use.
METHODS: This is a retrospective case series study. We retrospectively collected the clinical data of patients with sarcoma treated with knee joint inactivation and replantation and analyzed the efficacy of this surgical method. The bone healing and complications in these patients after inactivated autograft replantation were assessed.
RESULTS: This study included 16 patients. Fifteen patients had osteosarcoma, and one had Ewing\'s sarcoma. The average length of the inactivated bone is 20.2 cm (range 13.5-25.3 cm). All the patients underwent internal plate fixation. The average follow-up duration was 30 months (range 8-60 months). Before the data deadline of this study, eight (50%) patients were still alive, and eight (50%) died of sarcoma metastasis. Eight (50%) patients achieved bone healing at the diaphysis site of the inactivated tumor bone, with an average bone healing time of 21.9 months (range, 12-36 months). Five (31%) patients died due to metastases and did not achieve bone healing. Two (12.5%) patients did not achieve bone healing because of infection, and one (6.3%) patient underwent amputation due to tumor recurrence. Ten (62.5%) patients experienced fractures around the joint ends of the inactivated replanted bone, and eight of these ten patients were combined with joint dislocation.
CONCLUSIONS: The incidence of joint deformities after the knee-joint inactivation and replantation is extremely high and is not recommended for use.
摘要：
背景：自体肿瘤骨的灭活和再植是恶性肿瘤患者保肢的重要手术方法。目前,关于膝关节失活和再植的报道很少。在这项研究中,我们的目的是评估我们的手术方法的可行性。
方法：这是一项回顾性病例系列研究。我们回顾性收集应用膝关节失活再植治疗的肉瘤患者的临床资料，并分析该手术方法的疗效。评估了这些患者在灭活自体移植后的骨愈合和并发症。
结果：本研究包括16例患者。15例患者有骨肉瘤,还有一个得了尤因肉瘤.失活骨的平均长度为20.2cm(范围13.5-25.3cm)。所有患者均行钢板内固定。随访时间8～60个月,平均30个月。在本研究的数据截止日期之前，八位（50%）患者仍然活着，8人(50%)死于肉瘤转移。八名（50％）患者在灭活的肿瘤骨的骨干部位实现了骨愈合，平均骨愈合时间为21.9个月(范围，12-36个月）。五名（31％）患者因转移而死亡，未实现骨愈合。两名（12.5％）患者由于感染而未实现骨愈合，1例(6.3%)患者因肿瘤复发而截肢。10例（62.5%）患者在未激活的再植骨的关节端周围发生骨折，这10例患者中有8例合并关节脱位。
结论：膝关节失活和再植后关节畸形的发生率极高，不推荐使用。
方法：这是一项回顾性病例系列研究。我们回顾性收集应用膝关节失活再植治疗的肉瘤患者的临床资料，并分析该手术方法的疗效。评估了这些患者在灭活自体移植后的骨愈合和并发症。
结果：本研究包括16例患者。15例患者有骨肉瘤,还有一个得了尤因肉瘤.失活骨的平均长度为20.2cm(范围13.5-25.3cm)。所有患者均行钢板内固定。随访时间8～60个月,平均30个月。在本研究的数据截止日期之前，八位（50%）患者仍然活着，8人(50%)死于肉瘤转移。八名（50％）患者在灭活的肿瘤骨的骨干部位实现了骨愈合，平均骨愈合时间为21.9个月(范围，12-36个月）。五名（31％）患者因转移而死亡，未实现骨愈合。两名（12.5％）患者由于感染而未实现骨愈合，1例(6.3%)患者因肿瘤复发而截肢。10例（62.5%）患者在未激活的再植骨的关节端周围发生骨折，这10例患者中有8例合并关节脱位。
结论：膝关节失活和再植后关节畸形的发生率极高，不推荐使用。
