Abstract:
We present a case detailing the diagnosis and management of a periprosthetic giant cell tumour in a female patient in her 70s, who had undergone total knee arthroplasty (TKA) for primary osteoarthritis in her right knee 7 years prior. The patient reported 4 months of painful weight-bearing. Various imaging modalities, including plain radiographs, CT scans and MRI, revealed a sizeable lytic lesion beneath the TKA prosthesis, along with loosening of the tibial component.Blood tests and analyses of synovial fluid ruled out periprosthetic joint infection, and a biopsy confirmed the diagnosis of a giant cell tumour of the bone. Treatment entailed en bloc resection of the tumour and revision of the TKA using a hinged, oncological-type megaprosthesis. Surgical procedures involved careful resection of the proximal tibia, preservation of vasculature and the creation of a medial gastrocnemius muscle flap. Following surgery, the patient underwent supervised rehabilitation with a functional brace.
摘要:
我们介绍了一个案例,详细说明了一名70多岁的女性患者的假体周围巨细胞瘤的诊断和管理,7年前,她因右膝原发性骨关节炎接受了全膝关节置换术(TKA)。患者报告4个月的负重疼痛。各种成像模式,包括普通射线照片,CT扫描和MRI,显示TKA假体下方有相当大的溶解性损伤,随着胫骨组件的松动。血液检查和滑液分析排除了假体周围关节感染,活检证实了骨巨细胞瘤的诊断。治疗需要整体切除肿瘤并使用铰链修复TKA,肿瘤型巨型假体。外科手术包括仔细切除胫骨近端,血管的保存和腓肠肌内侧皮瓣的产生。手术后,患者接受了功能支具的监督康复治疗。