Giant cell tumor of bone. Curettage and cement reconstruction.
A retrospective review was conducted of all consecutive giant cell tumors treated by the senior author (JOJ) between 1975 and 1990 using the technique of aggressive curettage through a large bone window followed by acrylic cement reconstruction. Steinmann pins were used as reinforcement bars within the methacrylate in large lesions. Thirty-eight patients with a mean followup of 5.2 years (range, 2-16 years) were identified. Three (8%) recurrences are reported. There were no infections or mechanical failures of the construct. Functional results were good to excellent in 84% of patients. Ninety-five percent of patients reported good or excellent stability, no deformity, and emotional acceptance of the procedure. The recurrence rate with this protocol (8%) approached that associated with wide resection or amputation (0%-5%), and was lower than that seen with simple curettage and bone grafting (27%-55%). Acrylic cement reconstruction is a safe and effective procedure that provides local adjuvant therapy and immediate stability for early rehabilitation. The authors emphasize the importance of aggressive curettage of the lesion through a large bone window and suggest the use of reinforcement bars within the cement for large defects.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery* / Q000628:therapy; D003475:Curettage / Q000379:methods*; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies
D001843:Bone Cements; D008768:Methylmethacrylates