A Comparison of Outcomes of ‘Extensor Carpi Ulnaris Tenodesis’ versus ‘No Tenodesis’ after Resection of the Distal Ulna in Patients with Giant Cell Tumor

Abstract

Background: One of the methods of stabilizing the stump of the ulna following resection of the distal ulna is tenodesis of the extensor carpi ulnaris (ECU). Some studies have recommended stabilization, whereas others have not found it useful. Most of these studies have a mix of different pathologies and often do not have a control group. The aim of this study is to compare the outcomes of ECU tenodesis versus no tenodesis after resection of the distal ulna in patients with grade III giant cell tumor (GCT) of the distal ulna. Methods: The retrospective study included 10 patients with Campanacci grade III GCT of the distal ulna treated by resection of the distal ulna between 2014 and 2019. Patients were stratified into two groups based on whether they underwent ECU tenodesis (n = 5) or no tenodesis (n = 5). The patients were assessed at 6 weeks, 6 months, and 12 months for complications and outcomes using the Mayo wrist score (MWS) and the revised musculoskeletal tumor society score (MSTS). Results: The MWS and the MSTS were significantly better in the ECU tenodesis group at 6 weeks. At 6 months, MWS was similar in both groups, but MSTS continued to be significantly better in ECU tenodesis group. At 12 months, both groups reported similar MWS and MSTS. There were no recurrences in either groups. One patient in the ECU tenodesis group developed ECU tendonitis that resolved with conservative treatment. Conclusions: The outcomes of ECU tenodesis were better in the short term (6 months), although both groups reported similar outcomes at 12 months. Level of Evidence: Level III (Therapeutic)

Giant cell tumors of the distal ulna: long-term recurrence rate and functional outcomes of en bloc resection versus curettage in a multicenter study

“…In our series, the mean QuickDASH scores of patients for the different surgery types revealed no significant disability or slight disability compared with the general population. Similar results of favorable functional scores were found in the studies of Sahito et al [ 15 ] and Papanastassiou et al [ 36 ] In the Sahito et al [ 15 ] study, no significant differences in long-term outcomes were noted between patients that received ECU tenodesis versus those without tenodesis (MWS, 91 vs 89; MSTS, 29 vs 29.2). This result was similar to that of the Papanastassiou et al [ 36 ] study in which no obvious disparity in functional outcomes were revealed using QuickDASH or MSTS.…”

“…However, it is controversial whether any type of reconstruction is needed. Most previous studies employing reconstructions were limited to cases with heterogeneous tumors and case series with small sample sizes [ 8 , 15 ]. These considerations prompted us to conduct a multicenter retrospective cohort study comprising the largest series of patients to date with GCTB of the distal ulna.…”