Abstract
BackgroundGiant cell tumors (GCT) around the knee are common and pose a special problem of reconstruction after tumor excision, especially for grade III GCT. We questioned whether en bloc resection and reconstruction with alcohol inactivated autograft-prosthesis composite would provide (1) local control and long-term survival and (2) useful limb function in patients who had grade III GCT around the knee.MethodsWe retrospectively reviewed eight patients (5 males and 3 females) treated with this procedure with mean age of 31 years (range 20 to 43 years) from Jan 2007 to Oct 2008. 5 lesions were located in distal femur and 3 in proximal tibia. 4 patients were with primary tumor and the other 4 with recurrence. 2 patients showed pathological fracture.ResultsMean Follow-up is 54 months ranging from 38 to 47 months. No recurrence, metastasis, prosthesis loosening were found. The mean healing time between autograft and host bone was 5.5 months. The mean MSTS score was 26.3 (88%) ranging from 25 to 29. The mean ISOLS composite graft score was 32.8 (88.5%) ranging from 28 to 35. Creeping substitution is possibly the main way in bony junction. The healing time in femoral lesion is faster than that in tibial lesion.ConclusionsThe technique of alcohol inactivated autograft-prosthesis composite could be able to achieve satisfactory oncological and functional outcomes in Grade III GCT.
Highlights
Giant cell tumors (GCT) around the knee are common and pose a special problem of reconstruction after tumor excision, especially for grade III GCT
Since the local behavior of giant cell tumors can be aggressive and they have a greater risk of local recurrence, some authors advocate en bloc resection and reconstruction for these grade III lesions from the point of view of
We questioned whether en bloc resection and reconstruction with alcohol inactivated autograft-prosthesis composite would provide (1) local control and long-term survival and (2) useful limb function in patients who had grade III GCT around the knee
Summary
Giant cell tumors (GCT) around the knee are common and pose a special problem of reconstruction after tumor excision, especially for grade III GCT. Giant cell tumor (GCT) of bone is aggressive, potentially malignant lesion which remains a difficult and challenging management problem. The reconstruction of large bone defects and restoration of joint function resulting from resection of aggressive grade III GCT around knee remains a challenging problem. Since the local behavior of giant cell tumors can be aggressive and they have a greater risk of local recurrence, some authors advocate en bloc resection and reconstruction for these grade III lesions from the point of view of. We questioned whether en bloc resection and reconstruction with alcohol inactivated autograft-prosthesis composite would provide (1) local control and long-term survival and (2) useful limb function in patients who had grade III GCT around the knee. The objectives were to evaluate whether this method can provide both mechanical stability in early time and fine limb function in long time on the basis of complete resection and decreasing recurrence rate
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