Treatment of Giant-Cell Tumors of Long Bones with Curettage and Bone-Grafting*

Blackley, H.; Wunder, Jay S.; Davis, Aileen M.; White, Lynn Τ.; Kandel, Rita A.; Bell, Robert S.

doi:10.2106/00004623-199906000-00008

Cited by 293 publications

(270 citation statements)

References 22 publications

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“…However, we found that tumor recurrence for patients who received PMMA did not differ from patients who underwent a bone graft. These data were consistent with those of other studies, leading to questions regarding the benefit of PMMA [12,35,50] versus the potential for cartilaginous degeneration [6,49]. In our survey of 75 patients using PMMA or a bone graft, only one patient from each group reported having arthritis [16].…”

Section: Discussionsupporting

confidence: 90%

“…Extension of curettage has been achieved using a highspeed burr combined with adjuvant to preserve joint function, and this method has been associated with a low rate of recurrence (4%-14%) [5,6,12,13,23,25,27,36,44,48,52,53,56]. Therefore, our objective was to identify cases of GCTs of the distal radius to determine whether curettage is associated with lower rates of recurrences and fewer major complications compared with en bloc excision, and whether recurrence rates differed with the use of PMMA versus bone graft in patients treated with curettage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

Liu

Sun

2012

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

Liu

Sun

2012

Clinical Orthopaedics &Amp; Related Research

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“…All of the patients who had intralesional excision eventually were disease free, and two of the six patients with recurrences maintained their distal radial joint. Many large series of intralesional excision for giant cell tumors in all locations reported recurrences between 10% and 25% [2,8,10,11,16,19,30,35,38,39]. The distal radius is somewhat unique among locations for a giant cell tumor in that it has shown one of the highest rates of recurrence with intralesional surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous authors have identified the distal radius as being particularly prone to recurrence [2,8,10,13,16,21,30,[36][37][38][39]. The suspected contributing factors for this high rate of recurrence include the anatomic geometry of the distal radius, complexity of the distal radioulnar joint, and the paucity of surrounding muscle coupled with the close proximity of critical structures such as the median nerve, radial artery, and flexor and extensor tendons that make establishing wider margins challenging.…”

Section: Introductionmentioning

confidence: 99%

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

Wysocki

Soni

Virkus

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background A giant cell tumor is a benign locally aggressive tumor commonly seen in the distal radius with reported recurrence rates higher than tumors at other sites. The dilemma for the treating surgeon is deciding whether intralesional treatment is adequate compared with resection of the primary tumor for oncologic and functional outcomes. More information would be helpful to guide shared decision-making. Questions/purposes We asked: (1) How will validated functional scores, ROM, and strength differ between resection versus intralesional excision for a giant cell tumor of the distal radius? (2) How will recurrence rate and reoperation differ between these types of treatments? (3) What are the complications resulting in reoperation after intralesional excision and resection procedures? (4) Is there a difference in functional outcome in treating a primary versus recurrent giant cell tumor with a resection arthrodesis? Methods Between 1985 and 2008, 39 patients (39 wrists) were treated for primary giant cell tumor of the distal radius at two academic centers. Twenty patients underwent primary intralesional excision, typically in cases where bony architecture and cortical thickness were preserved, 15 underwent resection with radiocarpal arthrodesis, and four had resection with osteoarticular allograft. Resection regardless of reconstruction type was favored in cases with marked cortical expansion. A specific evaluation for purposes of the study with radiographs, ROM, grip strength, and pain and functional scores was performed at a minimum of 1 year for 21 patients (54%) and an additional 11 patients (28%) were available only by phone. We also assessed reoperations for recurrence and other complications via chart review.

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“…In this situation, the defect cavity can be reconstructed with polymethylmethacrylate [3,7,13], bone graft [2,4,5,12,23], or a bone substitute [19]. The use of cement has the potential advantage of restoring stability immediately but the longterm presence of cement in a weightbearing subchondral location may lead to degenerative changes in the articular surface [21].…”

Section: Introductionmentioning

confidence: 99%

Joint Preservation after Extensive Curettage of Knee Giant Cell Tumors

Ayerza

Aponte-Tinao

Farfalli

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Curettage is the most attractive procedure for surgically treating a giant cell tumor because it preserves joint function. However, since many giant cell tumors compromise subchondral bone this technique can jeopardize the articular surface with subsequent fractures or collapse. We asked whether intralesional curettage of a giant cell tumor close to the knee that combined morselized bone and cortical structural allograft would preserve joint function. We retrospectively reviewed 22 patients treated with that approach. The minimum followup was 2 years (average, 48 months; range, 24-80 months). The distal femur was involved in 12 patients and proximal tibia in 10. Complications and failures were recorded and functional results evaluated with Musculoskeletal Tumor Society score. We determined survivorship using the Kaplan-Meier technique using removal of the implant as the endpoint. The survival was 85% and the average functional score 28 points.

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Treatment of Giant-Cell Tumors of Long Bones with Curettage and Bone-Grafting*

Cited by 293 publications

References 22 publications

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

Joint Preservation after Extensive Curettage of Knee Giant Cell Tumors

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