Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination
Introduction: Recurrence after Giant Cell Tumour (GCT) treatment depends on the type of treatment used. Poly-Methyl-Meth-Acrylate (PMMA) after extended curettage provides structural support and allows for early identification of recurrence but carries a risk of thermal damage to the surrounding heal...
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Malaysian Orthopaedic Association
2024-11-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | https://www.morthoj.org/2024/v18n3/giant-cell-tumour.pdf |
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| author | Khan AQ Raza Q Abbas MB Chowdhry M Khan MJ |
| author_facet | Khan AQ Raza Q Abbas MB Chowdhry M Khan MJ |
| author_sort | Khan AQ |
| collection | DOAJ |
| description | Introduction: Recurrence after Giant Cell Tumour (GCT) treatment depends on the type of treatment used. Poly-Methyl-Meth-Acrylate (PMMA) after extended curettage provides structural support and allows for early identification of recurrence but carries a risk of thermal damage to the surrounding healthy tissue. The aim of this study was to compare long-term functional outcomes and complications in patients with GCT around the knee treated with extended curettage and bone grafting or cementation.
Materials and methods: All patients with biopsy-proven GCT, involving either the distal femur or proximal tibia, and treated with either curettage with bone grafting (CBG), curettage with bone cementation (CBC), or curettage combined with grafting and cementation (the Sandwich technique) were included. They were further classified according to Campanacci grading. Patients were followed for a minimum of two years, and all complications were recorded.
Results: The three groups showed a statistically significant difference in terms of persistent pain after surgery (p=0.03), development of long-term arthritis (p=0.01), as well as overall complications (p=0.005). There was no significant difference in terms of the overall recurrence rate between each group (p>0.05). For Campanacci Grade II lesions, there was a statistically significant difference in terms of local recurrence (p=0.01), with lower recurrence rates observed after cementation procedures.
Conclusion: The study indicates that the Sandwich technique was associated with a lower rate of complications compared to CBG or CBC. Patients in the CBG group reported persistent pain, while those in the CBC group exhibited early arthritic changes within five years of the index surgery. Although there was no overall difference in recurrence rates, cementation procedures had a significantly lower rate of recurrence in Campanacci Grade II lesions. |
| format | Article |
| id | doaj-art-a75ebe9d607246f89705fa2ca8c8598f |
| institution | Kabale University |
| issn | 1985-2533 2232-111X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj-art-a75ebe9d607246f89705fa2ca8c8598f2024-12-09T05:21:19ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2024-11-011831910.5704/MOJ.2411.006Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a CombinationKhan AQ0Raza Q1 Abbas MB2Chowdhry M3Khan MJ4Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh, IndiaDepartment of Orthopaedic Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh, IndiaDepartment of Orthopaedic Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh, IndiaDepartment of Orthopaedic Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh, IndiaDepartment of Orthopaedic Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh, IndiaIntroduction: Recurrence after Giant Cell Tumour (GCT) treatment depends on the type of treatment used. Poly-Methyl-Meth-Acrylate (PMMA) after extended curettage provides structural support and allows for early identification of recurrence but carries a risk of thermal damage to the surrounding healthy tissue. The aim of this study was to compare long-term functional outcomes and complications in patients with GCT around the knee treated with extended curettage and bone grafting or cementation. Materials and methods: All patients with biopsy-proven GCT, involving either the distal femur or proximal tibia, and treated with either curettage with bone grafting (CBG), curettage with bone cementation (CBC), or curettage combined with grafting and cementation (the Sandwich technique) were included. They were further classified according to Campanacci grading. Patients were followed for a minimum of two years, and all complications were recorded. Results: The three groups showed a statistically significant difference in terms of persistent pain after surgery (p=0.03), development of long-term arthritis (p=0.01), as well as overall complications (p=0.005). There was no significant difference in terms of the overall recurrence rate between each group (p>0.05). For Campanacci Grade II lesions, there was a statistically significant difference in terms of local recurrence (p=0.01), with lower recurrence rates observed after cementation procedures. Conclusion: The study indicates that the Sandwich technique was associated with a lower rate of complications compared to CBG or CBC. Patients in the CBG group reported persistent pain, while those in the CBC group exhibited early arthritic changes within five years of the index surgery. Although there was no overall difference in recurrence rates, cementation procedures had a significantly lower rate of recurrence in Campanacci Grade II lesions.https://www.morthoj.org/2024/v18n3/giant-cell-tumour.pdfgiant cell tumourextended curettagebone graftingcementationpmmasandwich technique |
| spellingShingle | Khan AQ Raza Q Abbas MB Chowdhry M Khan MJ Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination Malaysian Orthopaedic Journal giant cell tumour extended curettage bone grafting cementation pmma sandwich technique |
| title | Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination |
| title_full | Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination |
| title_fullStr | Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination |
| title_full_unstemmed | Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination |
| title_short | Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination |
| title_sort | long term functional outcomes of giant cell tumours around the knee treated by extended curettage followed by bone grafting cementation or a combination |
| topic | giant cell tumour extended curettage bone grafting cementation pmma sandwich technique |
| url | https://www.morthoj.org/2024/v18n3/giant-cell-tumour.pdf |
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