An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique

Slavko Tomić,Jelena Sopta,Zoran Rakočević,Marko Bumbaširević,Henry D Atkinson,Aleksandar Lešić

doi:10.1186/1749-799x-5-47

Slavko Tomić, Jelena Sopta + Show 4 more

Open Access

https://doi.org/10.1186/1749-799x-5-47

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Abstract

This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature.

Highlights

First described by Ewing in 1928, chondroblastomas were originally named “epiphyseal chondroblastomatous giant cell tumors of the proximal humerus” by Codman in 1931, and are often still termed Codman tumors [1,2,3,4]
Arising from the epiphyseal plate [9,10,11] and measuring between 1 and 7 cm [12], chondroblastomas are most frequently found in the proximal humerus, distal femur, proximal tibia, and the iliac bones [2,3,4,7,9,13,14,15,16]; they can appear in the talus, ribs and digits [17,18,19,20]
We report the case of a biologically aggressive chondroblastoma of the knee treated with a 13 cm en-bloc

Summary

Background

First described by Ewing in 1928, chondroblastomas were originally named “epiphyseal chondroblastomatous giant cell tumors of the proximal humerus” by Codman in 1931, and are often still termed Codman tumors [1,2,3,4] They occur mostly in the second decade of life, and are more common in males [5,6,7,8]. The patient was allowed to 50% partial weight-bear in a protective knee brace gradually working up to full weight-bearing at 4 months Despite cleaning his pin-sites with soap and water every day the patient developed superficial pin tract infections around the k-wires on 2 occasions. The patient is able to fully weight bear and stand independently on the operated leg (Figures 9 and 10)

Discussion

Conclusion

17. Assor B

Findings

32. Conway JD

34. Yadav SS