Techniques in the management of juxta-articular aggressive and recurrent giant cell tumors around the knee

Vidyadhara, S; Rao, Sharath K.

doi:10.1016/j.ejso.2006.05.023

Cited by 26 publications

(49 citation statements)

References 43 publications

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“…After curettage, treatment with adjuvants including highspeed burring, PMMA, hydrogen peroxide lavage, phenol cauterization, argon beam, and liquid nitrogen reduces recurrence rates to as low as 2% to 18% [1,14,20,26,29]. PMMA directly adjacent to articular cartilage may contribute to an increased risk of postoperative articular fractures and early degenerative osteoarthritis [2,8,20,24].…”

Section: Discussionmentioning

confidence: 99%

“…This helps to preserve joint integrity and maximize function without resorting to endoprosthetic replacements. Postoperative fracture and cartilage loss result in degenerative changes and arthritis [2,7,17,23,27,29]. The method of skeletal reconstruction may play a role in the future biologic integrity of the joint and result in subsequent fracture and degenerative changes.…”

Section: Introductionmentioning

confidence: 99%

“…Curettage alone with an intralesional margin has a recurrence rate of 40% to 60% [2,14,19,29,31]. Treatment with adjuvants such as high-speed burring, polymethylmethacrylate (PMMA), hydrogen peroxide lavage, phenol cauterization, argon beam, and liquid nitrogen may be used to extend the margin and reduce recurrence rates to as low as 2% to 18% [1,14,20,26,29].…”

Section: Introductionmentioning

confidence: 99%

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Supplemental Bone Grafting in Giant Cell Tumor of the Extremity Reduces Nononcologic Complications

Benevenia

Rivero

Moore

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Giant cell tumors (GCTs) are treated with resection curettage and adjuvants followed by stabilization. Complications include recurrence, fracture, and joint degeneration. Studies have shown treatment with polymethylmethacrylate (PMMA) may increase the risk of joint degeneration and fracture. Other studies have suggested that subchondral bone grafting may reduce these risks. Questions/purposes Following standard intralesional resection-curettage and adjuvant treatment, is the use of bone graft, with or without supplemental PMMA, (1) associated with fewer nononcologic complications; (2) associated with differences in tumor recurrence between patients treated with versus those treated without bone grafting for GCT; and (3) associated with differences in Musculoskeletal Tumor Society (MSTS) scores? Methods Between 1996 and 2014, 49 patients presented with GCT in the epiphysis of a long bone. Six patients were excluded, four who were lost to followup before 12 months and two because they presented with displaced, comminuted, intraarticular pathologic fractures with a nonreconstructable joint surface. The remaining 43 patients were included in our study at a mean followup of 59 months (range, 12-234 months). After resection-curettage, 21 patients were reconstructed using femoral head allograft with or without PMMA (JB) and 22 patients were reconstructed using PMMA alone (FRP, KSB); each surgeon used the same approach (that is, bone graft or no bone graft) throughout the period of study. The primary study comparison was between patients treated with bone graft (with or without PMMA) and those treated without bone graft. Results Nononcologic complications occurred less frequently in patients treated with bone graft than those treated without (10% [two of 21] versus 55% [12 of 22]; odds ratio, 0.088; 95% confidence interval [CI], 0.02-0.47; p = 0.002). Patients with bone graft had increased nononcologic complication-free survival (hazard ratio, 4.59; 95% CI, 1.39-15.12; p = 0.012). With the numbers available, there was no difference in tumor recurrence between patients treated with bone graft versus without (29% [six of 21] versus 32% [seven of 22]; odds ratio, 0.70; 95% CI, 0.1936-2.531; p = 0.586) or in recurrence-free survival among patients with bone graft versus without (hazard ratio, 0.94; 95% CI, 0.30-2.98; p = 0.920). With the numbers available, there was no difference in mean MSTS scores between patients treated with bone graft versus without (92% ± 2% versus 93% ± 1.4%; mean difference 1.0%; 95% CI, À3.9% to 6.0%; p = 0.675). Conclusions Compared with PMMA alone, the use of periarticular bone graft constructs reduces postoperative complications apparently without increasing the likelihood of tumor recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Supplemental Bone Grafting in Giant Cell Tumor of the Extremity Reduces Nononcologic Complications

Benevenia

Rivero

Moore

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…[53][54] Autografts vascularised or nonvascularised are used along with fixation which is either a locked long nail, or a long plate or sometimes an external fixator. 55 Distraction osteogenesis has been another option used particularly in benign tumors. An intramedullary nail, double osteotomy, fewer rings and early fixator removal have reduced the complication rates.…”

Section: Resection Arthrodesismentioning

confidence: 99%

“…An intramedullary nail, double osteotomy, fewer rings and early fixator removal have reduced the complication rates. 55 We have preferred to use a double barrel live fibula or an allograft combined with a live fibula and neutralized with a long plate. (fig 6) The defect can be bridged by using autograft or an allograft or a combination.…”

Section: Resection Arthrodesismentioning

confidence: 99%

Limb Salvage for Osteosarcoma: Current Status with a Review of Literature

Agarwal¹,

Nayak²

2012

Osteosarcoma

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The preferable treatment for cirrhotic portal vein thrombosis: Anticoagulation or transjugular intrahepatic portosystemic shunt?

Han

Fan

2009

Hepatology

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Techniques in the management of juxta-articular aggressive and recurrent giant cell tumors around the knee

Cited by 26 publications

References 43 publications

Supplemental Bone Grafting in Giant Cell Tumor of the Extremity Reduces Nononcologic Complications

Supplemental Bone Grafting in Giant Cell Tumor of the Extremity Reduces Nononcologic Complications

Limb Salvage for Osteosarcoma: Current Status with a Review of Literature

The preferable treatment for cirrhotic portal vein thrombosis: Anticoagulation or transjugular intrahepatic portosystemic shunt?

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