Qing Liu1,2, Hongbo He1, Yuhao Yuan1, Hao Zeng1, Yupeng Liu1, Can Zhang1, Wei Luo1. 1. Department of Orthopaedics, Xiangya Hospital, Central South University 87th Xiangya Road, Changsha, Hunan, China. 2. Department of Spine Surgery, The Second Xiangya Hospital, Central South University 139th Renmin Middle Road, Changsha, Hunan, China.
Abstract
AIMS: To explore and provide reasonable surgical options for recurrent giant cell tumors of bone (RGCTs) around the knee joint and compare the pros and cons of extended curettage (EC) and segmental resection (SR). MATERIALS AND METHODS: A retrospective analysis was performed of 22 patients (11 male, 11 female; mean age, 34.1 years) with RGCT around the knee joint treated in our hospital between June 2007 and June 2017. Average recurrence time was 14.2 ± 4.7 months. Basic clinical data, including Campanacci grade, lesion location, filler materials, pathological fracture, were recorded. Based on different reoperation methods, patients were divided into the EC and SR groups. Patients were regularly followed up; and recurrence, metastasis, local complications such as osteoarthritis, infection, prosthesis loosening, were recorded. Patient function and surgical efficacy were evaluated using the musculoskeletal tumor society (MSTS) score and Mankin score, respectively. RESULTS: Postoperative recurrence occurred in one patient in both groups, and no difference in the prognosis of oncology was observed between the groups. In the EC group, seven patients developed postoperative complications, but required no surgical treatment, whereas in the SR group, five patients developed postoperative complications and surgical treatment was performed on two patients. There were significant differences in the functional prognosis and surgical efficacy between the two groups; however, the EC group showed more satisfactory results. CONCLUSION: The oncological and functional prognosis of patients with RGCT around the knee joint is vital. EC should be considered as the first-line treatment, unless the tumors severely invade the surrounding soft tissues or are accompanied by complex fractures with significant displacement leading to no surgical curettage boundary. AJTR
AIMS: To explore and provide reasonable surgical options for recurrent giant cell tumors of bone (RGCTs) around the knee joint and compare the pros and cons of extended curettage (EC) and segmental resection (SR). MATERIALS AND METHODS: A retrospective analysis was performed of 22 patients (11 male, 11 female; mean age, 34.1 years) with RGCT around the knee joint treated in our hospital between June 2007 and June 2017. Average recurrence time was 14.2 ± 4.7 months. Basic clinical data, including Campanacci grade, lesion location, filler materials, pathological fracture, were recorded. Based on different reoperation methods, patients were divided into the EC and SR groups. Patients were regularly followed up; and recurrence, metastasis, local complications such as osteoarthritis, infection, prosthesis loosening, were recorded. Patient function and surgical efficacy were evaluated using the musculoskeletal tumor society (MSTS) score and Mankin score, respectively. RESULTS: Postoperative recurrence occurred in one patient in both groups, and no difference in the prognosis of oncology was observed between the groups. In the EC group, seven patients developed postoperative complications, but required no surgical treatment, whereas in the SR group, five patients developed postoperative complications and surgical treatment was performed on two patients. There were significant differences in the functional prognosis and surgical efficacy between the two groups; however, the EC group showed more satisfactory results. CONCLUSION: The oncological and functional prognosis of patients with RGCT around the knee joint is vital. EC should be considered as the first-line treatment, unless the tumors severely invade the surrounding soft tissues or are accompanied by complex fractures with significant displacement leading to no surgical curettage boundary. AJTR
Authors: M R Medellin; T Fujiwara; R M Tillman; L M Jeys; J Gregory; J D Stevenson; M Parry; A Abudu Journal: Bone Joint J Date: 2018-12 Impact factor: 5.082
Authors: Francois Gouin; Alexandre R Rochwerger; Antonio Di Marco; Philippe Rosset; Paul Bonnevialle; Fabrice Fiorenza; Philippe Anract Journal: Eur J Cancer Date: 2014-07-23 Impact factor: 9.162
Authors: R J O'Donnell; D S Springfield; H K Motwani; J E Ready; M C Gebhardt; H J Mankin Journal: J Bone Joint Surg Am Date: 1994-12 Impact factor: 5.284