Re-operation results in osteoarthritic change of knee joints in patients with giant cell tumor of bone

Abstract

Giant cell tumor of bone occasionally results in secondary osteoarthritic changes in adjacent joints. The purpose of this study was to determine the factors associated with the development of degenerative arthritis in surgically treated patients with giant cell tumor of the distal femur or proximal tibia and the effect of residual subchondral bone thickness on the location of recurrent giant cell tumor. We retrospectively studied 30 patients with giant cell tumor of bone arising around the knee joint treated with intralesional curettage, high-speed burring, and electrocauterization, followed by filling with polymethylmethacrylate or autogenous bone graft. There was no significant difference in factors of age, gender, tumor location, residual thickness of subchondral bone, or Campanacci grade correlated with the recurrence. Of the 10 recurrence cases, seven recurred on the articular side, and three on the contra-articular side of the primary lesion. Less than 5 mm of residual thickness of subchondral bone was correlated with recurrence on the articular side ( p = 0.038). There were 10 cases (33.3%), in which secondary degenerative arthritic change developed or progressed. Re-operation for local recurrence or post-operative fractures was a significant factor correlated with the progression of secondary osteoarthritis ( p = 0.010). Less residual thickness of subchondral bone tended to be associated with secondary osteoarthritis ( p = 0.068). Other factors were not correlated significantly with osteoarthritic change. These data support the contention that the residual thickness of subchondral bone could be a factor predicting the location of recurrence, and operative procedure to avoid re-operation might be critical to preserve knee function.