title: Treatment of large subchondral tumors of the knee with cryosurgery and composite reconstruction.
abstract: The radiographic and clinical outcomes of 9 patients with large benign aggressive or low-grade malignant periarticular tumors of the knee who were treated with cryosurgery and composite reconstruction (cementation, bone graft, and internal fixation) in lieu of primary resection were analyzed. The minimum followup was 2 years (range, 24-103 months). There were 6 giant cell tumors and a single case each of chondroblastoma, chondrosarcoma, and fibrosarcoma in the study group. Six lesions involved the distal femur and 3 the proximal tibia. Functional outcomes were graded according to the Enneking Modified System for the Functional Evaluation of Tumor and The Knee Rating Scale of The Hospital for Special Surgery. All lesions extended to within 2 mm of the articular surface. Local tumor control was achieved in 8 patients (89%). The single local recurrence was successfully managed with repeat curettage, cryosurgery, cementation, and internal fixation. All 9 patients had excellent functional outcomes according to both evaluation scales.
authors.affiliation: Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Aboulafia
authors.forename: D H
authors.initials: DH
authors.lastname: Rosenbaum
authors.forename: L
authors.initials: L
authors.lastname: Sicard-Rosenbaum
authors.forename: J S
authors.initials: JS
authors.lastname: Jelinek
authors.forename: M M
authors.initials: MM
authors.lastname: Malawer
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D003452:Cryosurgery; D003646:Debridement; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D013977:Tibia / Q000601:surgery; D014182:Transplantation, Autologous
chemical_list: D008768:Methylmethacrylates