Functional and radiographic evaluation of 214 aggressive benign bone lesions treated with curettage, cauterization, and cementation: 24 years of follow-up.
OBJECTIVE
Treatment with curettage, cauterization, and methylmethacrylate of aggressive benign bone lesions is a method now widely accepted in most orthopedic oncology centers. However, one of the controversies regarding this technique is the possible complications that may arise from the use of methylmethacrylate, which has caused some authors to remove it 2 years after the surgery and replace it with bone graft. The objective of this paper is to present a functional and radiographic evaluation of 214 patients presenting with aggressive benign bone lesions treated with curettage, cauterization, and methylmethacrylate from 1974 to 1998, with some of them having 24 years of follow-up. These patients were clinically and radiographically evaluated for the incidence of late osteoarthrosis, range of motion, and pain in the involved joint.


METHODS
This study comprised 214 patients, with an average follow-up duration of 10.6 years (range: 2 to 24 years. All cases involved aggressive benign lesions. The patients were evaluated according to the Musculoskeletal Tumor Society Score (MSTS) functional evaluation system, and the complications are described.


RESULTS
The MSTS functional evaluation was excellent in 166 cases (78%), good in 26 (12%), fair in 11 (5%), and poor in 11 (5%). The following complications were observed: late osteoarthrosis, 25 cases (12%); infection, 12 (6%); pathologic fracture, 11 (5%); and local recurrence, 19 (9%).


CONCLUSIONS
Based on clinical assessment, no significant deleterious effects directly related to the use of methylmethacrylate were observed. The functional evaluation performed in 1998 (up to 24 years of follow-up) did not show significant change when compared to the evaluation performed in 1985.
Camargo
Olavo Pires de
OP
Department of Orthopedics, Hospital das Clinicas, São Paulo University Medical School, São Paulo, SP, Brazil. olapcama@uol.com.br
Croci
Alberto Tesconi
AT
Oliveira
Cláudia R G M C de
CR
Baptista
André Mathias
AM
Caiero
Marcelo Tadeu
MT
D000293:Adolescent; D000328:Adult; D001843:Bone Cements / Q000009:adverse effects; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002425:Cautery; D002484:Cementation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003475:Curettage; D005260:Female; D005500:Follow-Up Studies; D005870:Giant Cell Tumors / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D020366:Methylmethacrylate / Q000009:adverse effects*; D011183:Postoperative Complications; D011859:Radiography; D016896:Treatment Outcome
D001843:Bone Cements; D020366:Methylmethacrylate