Clinical outcomes of chondroblastoma treated using synthetic bone substitute: risk factors for developing radiographic joint degeneration

Abstract

Background: Chondroblastoma (CB) is a rare locally aggressive bone tumor that commonly occurs in the epiphysis or apophysis of long bones. Although surgical treatment of CB carries potential risk for physeal or articular cartilage damage, risk factors for joint degeneration have not been well described. In addition, we have mainly used synthetic bone substitute (SBS) to fill the bone defect after intralesional curettage as treatment for CB. This study thus aimed to evaluate the incidence of and risk factors for adjacent-joint radiographic degeneration after SBS treatment for CB. Methods: We retrospectively reviewed 48 patients treated for CB at our institutions between 1996 and 2017. Clinical data, radiographic images, treatments, and local recurrence were analyzed. Results: We identified 40 patients [29 males and 11 females with a mean age of 19 years (range, 8-35 years)] who received SBS to fill the defect after curettage with a minimum follow-up of 1 year. The mean follow-up period was 71 months (range, 13-239 months). A total of 8 patients (20%) developed local recurrence. Radiographic analysis showed that 5 patients (16.7%) developed radiographic joint degeneration. Joint degeneration was significantly associated with the affected joint (p = 0.004). Conclusions: Curettage and SBS filling had been found to be a reasonable treatment method for CB, which commonly occurs in the epiphysis or apophysis. Radiographic joint degeneration was not uncommon after CB treatment, especially in the talus and proximal humerus.

“Dry Arthroscopy” is a Valuable Tool in the Excisional Curettage of Chondroblastoma: A Case Series

“…The use of an intraosseous arthroscope during chondroblastoma excision can improve intralesional visualization, confirm complete tumor excision, and assess cartilage integrity post-excision. Adjuvant treatments can lower local recurrence rates, but should ideally be utilized under direct visualization [ 5 , 6 , 7 , 8 , 9 ] and are made safer by arthroscopic assistance.…”

Sacral chondroblastoma — a rare location, a rare pathology: A case report and review of literature

“…Currently, in the treatment of patients with CB of long bones, thorough tumor curettage with high-speed grinding drills, bone cement filling or radiofrequency ablation can lead to a good long-term prognosis and preserve as much normal function of the limb as possible[ 28 , 29 ]. In addition to chemical (phenol), electrocautery or cryosurgery can be used as adjuvant treatment for CB patients[ 30 ].…”

Outcome of Chondroblastoma Treated With Intralesional Curettage and Autogenous Iliac Bone Graft: A Retrospective Study

“…Location, age, persist epiphysis and inadequate curettage once were considered a possible risk factor for recurrence, but still lack of reliable evidence or controversial [7,13,24]. Outani H et al [30] reported a 20% recurrence rate in their retrospective study of 40 patients with chondroblastoma, while the univariate analysis did not identify any signi cant risk factors for local recurrence. Ebeid WA et al [4] reported a retrospective study of 91 patients with chondroblastoma and found no statistical signi cance between the incidence of local recurrence and factors including age, sex, pathologic fracture or even the type of ller used.…”