Midterm follow-up results for 10 patients with giant cell tumor of the distal tibia treated by extended curettage, adjuvant liquid nitrogen, and autogenous bone graft.

Abstract

Background: The distal tibia is an unusual location for giant cell tumor. Less than 4% occurring in bone involve the foot and ankle region; the exact prevalence in the distal tibia is not known. Treatment remains unclear because of the rarity of the lesion in this location, the anatomy of the ankle, and difficulties associated with reconstruction. Methods: We retrospectively reviewed 10 patients who underwent extended curettage for giant cell tumor of the distal tibia, using adjuvant cryotherapy and biological reconstruction with autograft. The age of the patients ranged between 23-50 yr. Nine patients had newly diagnosed giant cell tumor while one patient presented with a recurrent lesion after simple curettage and synthetic bone grafting at another hospital. One patient presented with a nondisplaced pathological fracture of the distal tibia. He was treated initially with a short leg cast until the fracture healed, then surgical intervention was done. No intraarticular extension was present preoperatively in any patient. Results: The average follow-up from primary surgical intervention was 57 mo. At the end of the study, the mean musculoskeletal tumor score (MSTS) was 90. Local recurrence occurred in two patients. The average duration until union of the graft was 6.2 mo (range, 4-10 mo). Conclusions: Giant cell tumor of the distal tibia is a rare benign but aggressive tumor. Extended curettage and liquid nitrogen as adjuvant, followed by biologic reconstruction using autogenous bone graft is a solid line of treatment for lesions without intraarticular extension that provides good results.

Global Prevalence and Risk of Local Recurrence Following Cryosurgery of Giant Cell Tumour of Bone: A Meta-Analysis

“…Our literature search yielded 38 observational studies [ 4 , 5 , 6 , 7 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ] published between 1949 and 2016, which examined the outcome of cryosurgery in patients with giant cell tumours of the bone. Table 1 shows the detailed features of the included articles.…”

“…Our literature search yielded 38 observational studies [4][5][6][7] published between 1949 and 2016, which examined the outcome of cryosurgery in patients with giant cell tumours of the bone. Table 1 shows the detailed features of the included articles.…”

“…The symptoms of giant cell tumours are non-specific, such as pain, reduction in the affected joint’s range of motion, and swelling. The pathological fracture is usually associated with acute onset of pain, and the incidence of pathological fracture is approximately 10–22% [ 3 , 4 , 5 , 6 , 7 ]. The symptoms of giant cell tumours of the sacrum are usually subtle.…”