Cortical Window Reconstruction With Cement Augmented Screw Fixation After Intralesional Curettage of Low-Grade Chondrosarcomas: A Simple Method With Clinical Results

Abstract

Purpose:
 
 Intralesional curettage with a local adjuvant is a reliable surgical method in the treatment of low-grade chondrosarcomas (LGC). In order to maintain stability, some authors recommend osteosynthesis following intralesional treatment. However, larger osteosynthesis materials may increase complications as well as disturbing postoperative MRI evaluation. In this study, we describe a simple method of cortical window reconstruction with cement-augmented screw fixation.
 
 Methods:
 
 22 patients with LGC were enrolled in this retrospective study who underwent surgical intervention between 2011-2021. All patients were treated in the same manner by intralesional curettage, cement augmentation and fixation with titanium screws embedded in the cement. The clinical outcome was assessed, using the MSTS Score.
 
 Results:
 
 The mean age at diagnosis was 44,5 and the mean follow up duration was 56,2 months. The mean long dimension of the cortical window was 4,8 cm for reconstructions with one screw and 6,2 cm for reconstructions with two screws. All of the patients showed excellent clinical outcomes with a mean MSTS score percentage of 91,3. We did not encounter any major complications postoperatively. On MRI evaluations, the image distortion due to thin titanium screw was minimal and cement bone interface was clearly visible without any disturbance.
 
 Conclusion:
 
 The convenient use of cement-augmented screw fixation may be a good tool for the reconstruction of cortical window in the treatment of intramedullary tumours of long bones and give a potential chance of obtaining better MRI images without any disturbances postoperatively.