RESUMO
A segmental resection and rotationplasty was performed in 23 patients with malignant and aggressive benign tumor of the distal femur or proximal tibia between February 1988 and September 1992 at the Severance Hospital. There were 13 male and 10 female patients. The yongest was 5 years old and the oldest was 37 years old. Mean age at operation was 26.2 years. Of the 23 cases, 14 were osteosarcoma, 7 were giant cell tumor and 2 were synovial sarcoma. After an average observation period of 32.5 months, there was no evidence of local recurrence but 6 distant metastases were developed. According to Shriner's rating scale, the functional result were excellent or good in all cases. All patient were convinced that they had chosen the appropriate operative procedure and the ability to achieve high level of activity was considered as the main benefit.
Assuntos
Feminino , Humanos , Masculino , Fêmur , Tumores de Células Gigantes , Joelho , Metástase Neoplásica , Osteossarcoma , Recidiva , Sarcoma Sinovial , Procedimentos Cirúrgicos Operatórios , TíbiaRESUMO
The results of cementless total knee arthroplasty(TKA) have improved steadly during the past decade due to development of design, fixation and surgical technique. We analyzed the results of 45 total knee arthroplasties performed with Anatomic Modular Knee(AMK) prosthesis at the department of Orthopedic Surgery, Yonsei University College of Medicine between June 1989 and December 1991 and compared their results of rheumatoid arthritis(RA) and osteoarthritis(OA) patients. The follow up ranged from 2 years to 4 years and 2 months (average 2 years and 8 months). Using the Hospital for Special Surgery(H.S.S.) rating system and Knee Society(K.S.) clinical rating system, we found that the clinical results were similar for RA group(Average; H.S.S. 86.1, K.S. 81.2/74.4) and OA group(Average; H.S.S. 88, K.S. 87.8/77.1) even though the preoperative knee score was lower in RA group(Average;H.S.S.42.8) than OA group(Average;H.S.S. 57.7). The average age of RA patients was 14 years younger than that of OA patients. The improvement of range of motin and preoperative flexion contracture after TKA was remarkable in RA group. The radiologic evaluation based on Knee Society roentgenographic evaluation system revealed proper alignment of all component and no definite radiologic loosening except 1 case in which postoperative deep infection had occurred. On the basis of this prospective clinical and radiologic review, we concluded that uncemented implantation of AMK prosthsis both in RA and OA patients was encouraging.
Assuntos
Humanos , Artrite Reumatoide , Artroplastia , Artroplastia do Joelho , Contratura , Seguimentos , Joelho , Ortopedia , Osteoartrite , Estudos Prospectivos , Próteses e ImplantesRESUMO
The giant cell tumor is an rather common primary bone tumor of young adult 20 to 40 years of age, most frequently found around the knee joint and the distal end of the radius. So the normal life expectancy and the active life style of patient necessitate a reliable and durable surgical remedy for eradicating the tumor and preserving joint function. Although almost are benign, sometimes these tumors are locally invasive and tend to have a high rate of recurrence, and malignant transformation is well known. Thus, a satisfactory method of treatment has not yet be found. Clinical observation were carried out on 44 cases of giant cell tumor of bone in the department of Orthopedic Surgery, Yonsei University College of Medicine from January 1981 through November 1991. Mean follow-up period was 2 years and 9 months. The age incidence was most frequent in third decade (50.0%), with male predominence as a whole. Usual location of the lesion was around the knee(70.5%). The recurrence rate for total cases was 25%: 46.2% after curettage and bone graft ; 25% after curettage and bone cement filling : no recurrence after segmental resection and replantation or amputation. We analyzed the recurrence rate according to the Jaffe s pathologic grades. It looked like higher incidence of local recurrence with higher grade. But due to the small number of patients and short follow-up, we need more cases and follow-up. The local recurrence was noted even after 2 years postoperatively, long term fol low-up is need to find it.