膝部前面の悪性軟部腫瘍に対する遊離広背筋皮弁術と処理組織を用いた伸展機構の再建  [in Japanese] Reconstructive Surgery of Extensor Mechanism Using Free Flap of Latissimus Dorsi and Recycled Tissue Following Resection of Soft Tissue Sarcoma Located in the Anterior Knee  [in Japanese]

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Author(s)

    • 辻井 雅也 TSUJII Masaya
    • 三重大学大学院医学系研究科整形外科 Department of Orthopaedic Surgery, Graduate School of Medicine Mie University
    • 國分 直樹 KOKUBU Naoki
    • 三重大学大学院医学系研究科整形外科 Department of Orthopaedic Surgery, Graduate School of Medicine Mie University
    • 中村 知樹 NAKAMURA Tomoki
    • 三重大学大学院医学系研究科整形外科 Department of Orthopaedic Surgery, Graduate School of Medicine Mie University
    • 松原 孝夫 MATSUBARA Takao
    • 三重大学大学院医学系研究科整形外科 Department of Orthopaedic Surgery, Graduate School of Medicine Mie University
    • 淺沼 邦洋 ASANUMA Kunihiro
    • 三重大学大学院医学系研究科整形外科 Department of Orthopaedic Surgery, Graduate School of Medicine Mie University
    • 須藤 啓広 SUDO Akihiro
    • 三重大学大学院医学系研究科整形外科 Department of Orthopaedic Surgery, Graduate School of Medicine Mie University

Abstract

It is difficult to reconstruct the extensor mechanism of the knee joint following extensive resection for malignant soft tissue sarcoma generated in the anterior surface of the knee joint. We introduced a surgical technique for this condition using recycled tissue including bone and tendon, and free myocutaneous flap of latissimus dorsi. Three patients surgically underwent wide resection for malignant soft tissue sarcoma in the anterior knee. Then, the resected tissue was devitalized for tumor cells using irradiation or pasteurization. This recycled tissue included the inferior patella, patellar ligament, and anterior proximal tibia with tuberosity. The recycled tissues were fixed on both sides and covered by the free latissimus dorsi myocutaneous flap. All patients had good function with neither recurrence of sarcoma nor complications at an average of 3.5 years after the surgery. Moreover, histological findings demonstrated remodeling of recycled tendon with longitudinal arrangement of tendon cells, which was resected in the debulking surgery. In contrast to easier techniques, there is concern over reconstructive surgery using recycled tissue in terms of various problems including infection and mechanical weakness. The present report suggests that the transferred tissue with rich circulation could promote remodeling of recycled tissue as well as decreased complications such as infection.

Journal

  • Journal of Japanese Society of Reconstructive Microsurgery

    Journal of Japanese Society of Reconstructive Microsurgery 28(2), 47-51, 2015

    Japanese Society of Reconstructive Microsurgery

Codes

  • NII Article ID (NAID)
    130005083653
  • Text Lang
    JPN
  • ISSN
    0916-4936
  • Data Source
    J-STAGE 
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