| Objective To analysis making treatment protocols in different campannacci grading patients,we retrospectively analysised the Postoperative Therapeutic effect of the patients treated with intralesional surgery or marginal surgery.Methods We retrospectively reviewed the records of59patients with GCT of the extremities treated at the department of orthopaedics, second affiliated hospital, medical college of Zhejiang Uniuersity from Jan2004to Oct2011.Intraslesional surgery group including curettage, allograft, autograft,tumor inactivated contains26cases.Marginal surgery group including segmental resection, fibular autograft, Prothesis Replacement contains33cases.After the follow up, retrospectively analysis the recurrence rate,complications and the musculoskeletal tumor society score(MSTS) developed by Enneking between the two surgery groups.The numeration data was tested by chi-square test, T test to the mean difference. Statistical analysis was carried out using the SPSS software version16.0.Results The recurrence rate of the marginal surgery group is Statistically lower than the intraslesional surgery group.The chi-square value is5.59,P=0.018(P<0.05).The complications after the operation and the MSTS of the marginal surgery group is quite worse than the intraslesional surgery group however there is no Statistical difference between the two groups.The patients with a relapsed history are more likely to relapse. The chi-square value is4.90,P=0.027(P<0.05)Conclution The correct surgical protocols should made after meticulous estimating patient’s condition in every single case. The patients treated by marginal surgery are less likely to be relapse than those who treated by intraslesional surgery.The surgical protocols are made mainly according to the horizontal axis of the invasived range and the range of the chondral articular surface aggressived by GCT.The adaptive marginal operation can lead to similar recovery of function to the intraslesional surgery.However the adjuvant therapy should be taken in the intraslesional operation to remove the lesions completely.Once the recurrence show up,the recurrence rate is higher. |
