Curettage and reconstruction by the sandwich technique for giant cell tumours around the knee

Abstract

To evaluate outcomes of 12 patients who underwent curettage, use of phenol, and reconstruction using the sandwich technique for giant cell tumour (GCT) of bone around the knee. Methods: 7 women and 5 men aged 20 to 45 (mean, 28.5) years underwent intralesional curettage, use of phenol, and reconstruction using the sandwich technique for GCT of the proximal tibia (n=7) or distal femur (n=5). One of the cases were recurrences. Two, 18, and 9 tumours were classified as grade I, grade II, and grade III, respectively. Five of the grade III tumours were associated with an extra-articular pathological fracture. Patients underwent intralesional curettage, use of phenol, and reconstruction with allograft, gel foam, and cement (the sandwich technique). Pathological fractures were fixed with plates. Functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) score. Results:The mean follow-up period was 2 (2.5-11) years. The mean MSTS score was 28.7 out of 30 (standard deviation, 3; range, 16-30). One patient with a grade III tumour in the proximal tibia had a recurrence detected elsewhere after 2 years. Her MSTS score at 2 years was 22. No patient had malignant transformation. Conclusion: Intralesional curettage, use of phenol, and reconstruction with allograft, gel foam, and cement (the sandwich technique) for GCT of bone achieved good functional outcome and a low recurrence rate.