肿瘤骨灭活再植重建髋关节

髋关节周围的恶性肿瘤，因涉及髋关节的功能，最好做假体置换。但假体价格昂贵，患者难以普遍接受，肿瘤骨灭活再植不失为一种有效地方法。在有效的术前、术后化疗支持下，可靠的手术边缘为基础的情况下，肿瘤骨灭活再植可以达到重建髋关节的效果。瘤骨壳灭活再植的优点表现在大小、外形合适，无明显的排异反应，愈合后能达到生物固定的目的。1986年，国内积水潭医院首先报道了乙醇灭活再植的试验研究。目前临床应用的肿瘤骨灭活的方法有乙醇灭活再植、煮沸灭活再植以及微波灭活法等方式达到消灭肿瘤的目的。

肿瘤骨灭活再植术局部复发率高，容易发生感染以及骨折不愈合等并发症，目前临床应用有减少的趋势。

参考文献

[1]Meyers MH.Present status of joint transplantation.Contemp Orthoped,1981,3:64-71

[2]Ivins JC.Nonbiologic implants in limb saving tumor surgery.//Chao EY,Ivins JC,eds.Tumor prostheses for bone and joint reconstruction.The design and application.1st ed.New York:Thieme-Stratton Inc,1983:3-6

[3]Moore AT,Bohlman HR.Metal hip replacement:A case report.J Bone Joint Surg,1943,25:688-692

[4]Scales JT.Massive bone and joint replacement involving the upper femur,acetabulum,and iliac bone.Proc Sci Met Hip Soc,1975,3:245-275

[5]Chao EY,Sim FH.Tumor prostheses design.A system approach.//Chao EY,Ivins JC,eds.Tumor prostheses for bone andjoint reconstruction.The design and application.1st ed.New York:Thieme-Stratton Inc,1983:335-359

[6]Barr JS,Eaton RG.Elbow reconstruction with a new prosthesis to replace the distal end of the humerus.A case report.J Bone Joint Surg(Am),1965,47:1408-1413

[7]Enneking WF,Dunham W,Gebhardt MC,et al.A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system.Clin Orthop Relat Res,1993,286:241-246

[8]Sanjay BK,Moreau PG.Limb salvage surgery in bone tumour with modular endoprosthesis.Int Orthop.1999,23(1):41-46

[9]Morris HG,Capanna R,Campanacci D,et al.Modular endoprosthetic replacement after total resection of the femur for malignant tumour.Int Orthop,1994,18(2):90-95

[10]Zehr RJ,Enneking WF,Scarborough MT.Allograft-prosthesis composite versus megaprosthesis in proximal femoral reconstruction.Clin Orthop Relat Res,1996,(322):207-223

[11]Markel MD,Wood SA,Bogdanske JJ,et al.Comparison of healing of allograft/endoprosthetic composites with three types of gluteus medius attachment.J Orthop Res,1995,13(1):105-114

[12]Langlais F,Lambotte JC,Collin P,et al.Longterm results of allograft composite total hip prostheses for tumors.Clin Orthop Relat Res,2003,414:197-211

[13]Gottsauner-Wolf F,Egger EL,Giurea A,et al.Biologic attachment of an allograft bone and tendon transplant to a titanium prosthesis.Clin Orthop Relat Res,1999,358:101-110

[14]Chao EY,Sim FH.Composite fixation of salvage prostheses for the hip and knee.Clin Orthop Relat Res,1992,276:91-101

[15]Kalteis T,Handel M,Bäthis H,et al.Imageless navigation for insertion of the acetabular component in total hip arthroplasty:is it as accurate as CT-based navigation?J Bone Joint Surg Br,2006,88(2):163-167

[16]Lazovic D,Kaib N.Results with navigated bicontact total hip arthroplasty.Orthopedics,2005,28(10 Suppl):1227-1233

[17]Rosen G,Caparros B,Huvos AG,et al.Preoperative chemotherapy for osteogenicsarcorna:selection of post operative adjuvant chemotherapy based on the response of primary tumor to preoperative chemotherapy[J].Cancer,1982,49(6):1221-1230

[18]Link M P,Goorin A M,Miser A W,et al.The effect of adjuvant chemotherapy on relapsefree survival in patients with osteosarcoma of the extremity[J].N Engl J Med,1986,314:1600-1606

[19]Jaffe N.Recent advances in the chemotherapy of metastatic osteogenic sarcoma[J].Clin Orthop,1991,270(4):4-7

[20]Marina N,Gebhardt M,Teot L,et al.Biology and therapeutic advances for pediatric osteosarcoma[J].Oncologist,2004,9(4):422-441

[21]Fuchs N,Bielack SS,Epler D,et al.Long-term results of the co-operative German-Austrian-Swiss osteosarcoma study groups protocol COS~86 of intensive multidrug chemotherapy and surgery for osteosarcoma of the limbs[J].Ann Oncol,1998,9(8):893-899

[22]Bielack SS,Machatschek JN,Flege S,et al.Delaying surgery with chemotherapy for osteosarcoma of the extremities[J].Expert Opin Pharmacother,2004,5(6):1243-1256

[23]Longhi A,Errani C,De Paolis M,et al.Primary bone osteosarcoma in the pediatric age:state of the art[J].Cancer Treat Rev,2006,32(6):423-436

[24]Biedler JL.Genetic aspects of multidrug resistance[J].Cancer,1992,70(Suppl 6):1799-1809

[25]Bruheim S,Bruland OS,Breistol K,et al.Human osteosarcoma xenografts and their sensitivity to chemotherapy[J].Pathol Oncol Res,2004,10(3):133-141

[26]Rosenbaum C,Rohrs S,Muller O,et al.Modulation of MRP-1-mediated multidrug resistance by indomethacin analogues[J].J Med Chem,2005,48(4):1179-1187

[27]Takeshita H,Kusuzaki K,Ashihara T,et al.Intrinsic resistance to chemotherapeutic agents in murine osteosarcoma cells[J].J Bone Joint Surg Am,2000,82-A(7):963-969

[28]Larkin A,O’Driscoll L,Kennedy S,et al.Investigation of MRP-1 protein and MDR-1 P-glycoprotein expression in invasive breast cancer:a prognostic study[J].Int J Cancer,2004,112(2):286-294

[29]Kandel RA,Campbell S,Noble S,et a1.Correlation of P-glycoprotein detection by immunohistochemistry with mdr-1 mRNA levels in osteosarcomas[J].Diagn Mol Patho1,1995,4:59-65

[30]Wunder J S,Bull S B,Aneliunas V,el a1.Mdr-1 geneexpression and outcome in osteosarcoma:a prospective,multicenter study[J].Clin Oncol,2000,l8:2685-2694

[31]Chou AJ,Gorlick R.Chemotherapy resistance in osteosarcoma:current challenges and future directions[J].Expert Rev Anticancer Ther,2006,6(7):1075-1085

[32]MA Wanli,CHEN Zenghai,CHEN Peng,et a1.The application of thermochemotherapy in limbsalvage surgery for osteosarcoma[J].Chin J Bone Tumor&Bone disease,2005,4(4):214-216

[33]Van Leenders GJ,Beerlage HP,RuiJter ET,et a1.Histopathological changes associated with high intensity focused u1trasound treatment for localized adenocarcinoma of the prostate[J].C1in Pathol,2000,53(5);391-394

[34]van der Veen AH,De Wilt JH,Eggermont AM,et a1.TNF-alpha augments intratumoural concentrations of doxorubicin in TN F-alpha-based isolated limb perfusion in rat sarcoma models and enhances anti-tumour effects[J].Br J Cancer,2000,82(4):973

[35]Jia SF,Kleinerman ES.Antitumor activity of TNF-α、IL-1 and TNF-αagainst three human osteosarcoma cells line[J].Lymphokine-Cytotine-Res,1991,10:28l

[36]Grunhagen DJ,de Wilt JH,Ten Hagen TL,et al.Technology insight:Utility of TNF-alpha-based isolated limb perfusion to avoid amputation of irresectable tumors of the extremities[J].Nat Clin Pract Oncol,2006,3:94-103

[37]Lejeune FJ,Lienard D,Matter M,et al.Efficiency of recombinant human TNF in human cancer therapy[J].Cancer Immun,2006,6:6

[38]Rosenberg SA,Spiess P,Lafreniere R.A new approach to adoptive immunotherapy of cancer with tumorinfiltrating lymphcytes[J].Science,1986,233:1318

[39]Mori K,Redini F,Gouin F,et al.Osteosarcoma:current status of immunotherapy and future trends[J].Oncol Rep,2006,15(3):693-700

[40]Ternovoi VV,Curiel DT,Smith BF,et al.Adenovirus-mediated p53 tumor suppressor gene therapy of osteosarcoma[J].Lab Invest,2006,86(8):748-766

[41]Tsang WP,Chan SP,Fung KP,et a1.Modulation of multidrug resistance-associated protein-1(MRP-1)by p53 mutant in SaoS-2 cells[J].J Cancer Chemother Pharreaco1,2003,51:l61-166

[42]Hellwinkel OJ,Muller J,Pollmann A,et a1.Osteosarcoma ce1l lines display variable individual reactions on wildtype p53 and Rb tumorsuppressor transgenes[J].J Gene Med,2004,11:542-549

[43]Song SU,Boyce FM.Cobination treatment for osteosarcoma with baculoviral vector mediated gene therapy(p53)and chemotherapy(adriamyci n)[J].J Exp Mol Med,2001,33:46-53

[44]Nakase M,Inui M,Okumura K,et al.p53 gene therapy of human osteosarcoma using a transferring-modified cationic liposome[J].Mol Cancer Ther,2005,4(4):625-631

[45]Wang H,Nan L,Yu D,et a1.Antisense anti-MDM2 oligonucleotides as a novel therapeutic approach to human breast cancer;in vitro and in vivo activities and mechanisms[J].Clin Cancer Res,2001,7(11):3613-3624

[46]Sato N,Mizumoto K,Maehara N,et a1.Enhancement of drug-induced apoptosis by antisense oligodeoxynucleotides targeted against mdm2 and p21WAF1/CIP1[J].Anticancer Res,2000,20(2A):837-842

[47]Kim R,Tanabe K,Emi M,et al.Potential roles of antisense therapy in the molecular targeting of genes involved in cancer[J].Int J Oncol,2004,24(1):5-17

[48]Matsumoto Y,Miyake K,Kunishio K,et al.Reduction of expression of the multidrug resistance protein(MRP)1 in glioma cells by antisense phosphorothioate oligonucleotides[J].J Med Invest,2004,51(3-4):194-201

[49]Ketola A,Maatta AM,Pasanen T,et a1.Osteosarcoma and chondro-sarcoma as targets for virus vectors and herpes simplex virus thymidine kinase/ganciclovir gene therapy[J].Int J Mol Med,2004,13(5):705-710

[50]Mayer MN,Grier CK.Palliative radiation therapy for canine osteosarcoma[J].Can Vet J,2006,47(7):707-709

[51]Enneking WF,Dunham WK.Resection and reconstruction for primary neoplasms involving the innominate bone[J].J Bone Joint Surg Am,1978,60(6):731-746

[52]Campanacci M,Capanna R.Pelvic resections:the Rizzoli Institute experience[J].Orthop Clin North Am,1991,22(1):65-86

[53]JIANG Huai,LU Jianjun,XIE Wei,et al.Surgical treatment for pelvic tumors[J].Chin J Bone Tumor&Bone Disease,2007,6(6):332-336

[54]Finkemeier CG.Bone-grafting and bonegraft substitutes.J Bone Joint Surg Am,2002,84(3):454-464

[55]Leblebicioglu G.Reliability of vascularized fibula in maintaining arthrodesis following extra-articular wide excisions of malignant musculoskeletal tumors.Saudi Med J,2006,27(8):1204-1211

[56]Gebert C,Hillmann A,Schwappach A,et al.Free vascularized fibular grafting for reconstruction after tumor resection in the upper extremity.J Surg Oncol,2006,94(2):114-127

[57]Parrett BM,Matros E,Pribaz JJ,et al.Lower extremity trauma:trends in the management of soft-tissue reconstruction of open tibia-fibula fractures.Plast Reconstr Surg,2006,117(4):1315-1322

[58]Basarir K,Selek H,Yildiz Y,et al.Nonvascularized fibular grafts in the reconstruction of bone defects in orthopedic oncology.Acta Orthop Traumatol Turc,2005,39(4):300-306

[59]Chow LC,Napoli A,Klein MB,et al.Vascular mapping of the leg with multidetector row CT angiography prior to free-flap transplantation.Radiology,2005,237(1):353-360

[60]Safoury Y.Free vascularized fibula for the treatment of traumatic bone defects and nonunion of the forearm bones.J Hand Surg,2005,30(1):67-72

[61]Lee KS,Han SB,Baek JR.Free vascularized osteocutaneous fibular graft to the tibia in 51 consecutive cases.J Reconstr Microsurg,2004,20(4):277-284

[62]YU Guang-rong,YUAN Feng,ZHANG Shimin,et al.Resection of periacetabular tumors and reconstruction with fibular autograft[J].Chin J Orthop,2006,26(6):371-375

[63]Hou CH,Yang RS,Hou SM.Hospital-based allogenic bone bank-10-year experience.J Hosp Infect,2005,59(1):41-45

[64]Manabe J,Ahmed AR,Kawaguchi N,et al.Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma.Clin Orthop,2004,419:258-266

[65]Jeon DG,Kim MS,Cho WH,et al.Pasteurized autograft-prosthesis composite for distal femoral osteosarcoma.J Orthop Sci,2007,12(6):542-549

[66]Tsuchiya H,Wan SL,Sakayama K,et al.Reconstruction using an autograft containing tumour treated by liquid nitrogen.J Bone Joint Surg Br,2005,87(2):218-225

[67]Fan QY,Ma BA,Qlu XC,et al.Preliminary report on treatment of bone tumors with microwave-induced hyperthermia.Bioelectromagnetics,1996,17(3):218-222

[68]Fan QY,Ma BA,Zhou Y,et al.Bone tumors of the extremities or pelvis treated by microwave-induced hyperthermia.Clin Orthop,2003,406:165-175

[69]LIN Nong,YE Zhao-ming,LI Wei-xu,et al.Endoprosthetic reconstruction for neoplasms of the proximal femur in limb salvage surgery[J].Chin J Joint Surg(Electronic Version),2007,1(5):275-280

[70]Bickels J,Meller I,Nirkin A,et al.Successful conversion of a total femur knee-arthrodesing prosthesis to a functional knee construct-a case report.Acta Orthop,2007,78(5):698-700

[71]Markel MD,Wood SA,Bogdanske JJ,et al.Comparison of healing of allograft/endoprosthetic composites with three types of gluteus medius attachment.J Orthop Res,1995,13(1):105-114

[72]Langlais F,Lambotte JC,Collin P,et al.Long-term results of allograft composite total hip prostheses for tumors.Clin Orthop,2003,414:197-211

[73]GUO wei,XU wan-peng,LI Nan,et al.Surgical treatment for primary malignant pelvic tumors[J].Chin J Orthop,2005,25(5):276-279

[74]Unwin PS,Cannon SR,Grimer RJ,et al.Aseptic loosening in cemented custom-made prosthetic replacements for bone tumours of the lower limb.J Bone Joint Surg Br,1996,78(1):5-13

[75]White RH,Gettner S,Newman JM,et al.Predictors of rehospitalization for symptomatic venous thromboembolism after total hip arthroplasty[J].N Engl J Med,2000,343(24):1758-1764

[76]Heekin RD,Callaghan JJ,Hopkinson WJ,et al.The porous-coated anatomic total hip prosthesis,inserted without cement[J]J Bone Joint Surg Am,1993,75(1):77-91

[77]Shih LY,Sim FH,Pritchard DJ,et al.Segmental total knee arthroplasty after distal femoral resection for tumor.Clin Orthop Relat Res,1993,(292):269-281

[78]Turula KB,Friberg O,Lindholm TS,et al.Leg length inequality after total hip arthroplasty[J].Clin Orthop Relat Res,1986,(202):163-168

[79]Austin MS,Hozack WJ,Sharkey PF,et al.Stability and leg length equality in total hip arthroplasty[J].J Arthroplasty,2003,18(3 Suppl 1):88-90

[80]Hsu RW,Sim FH,Chao EY.Reoperation results after segmental prosthetic replacement of bone and joint for limb salvage.J Arthroplasty,1999,14(5):519-526

[81]Kusuzaki K,Shinjo H,KimW,et al.Resect hip parthropiasty for malignant pelvictumor Outcome in 5 patients followed more than 2 years.Acta Orthop scand.1998,69:617-621

[82]郭 仪，徐万鹏．骨盆肿瘤的切除与重建［J］．中国骨肿瘤骨病，2004,1:1-4

[83]俞光荣，袁 锋，张世民，等．髓臼周围肿瘤的切除与腓骨移植重建．中华骨科杂志，2006,6:371-376

[84]SatCher Jr RL,O’Donnell R J.Reconstruction of the pelvis after resection of tumors about the acetabulum.Clin Orthop RelaLRes,2003,409:209-217

[85]Takam i M,Ieguchi M,Takamatsu K,et al Functional evaluation of flail hip joint after periacetabular resection of the pelvis.Osaka City Med J,1997,43:173-183

[86]Springfield D.Autograft reconstructions.Orthop Clin North Am,1996,21(5):483-492

[87]屠币棋，龚 全，裴复兴，等．大块冷冻同种异体骨移植后免疫学改变，中华骨科杂志，2000,20(7):421-423

[88]Belirs,Davis AM,Wunder JS,et al.Allograft reconstruction of the acetabulum after resection of stage-ⅡB sarcoma[J].Journal of Bone and Joint Surgery,1997,11:1663-1668