[Vascularized fibular combined with iliac grafting to repair bone defect after tumor extensive resection for giant cell tumor of bone around knee].
OBJECTIVE
To study the method and effect of the vascularized fibular combined with iliac grafting after the tumor extensive resection for giant cell tumor of the bone around the knee.


METHODS
Twenty-five patients with giant cell tumor of the bone around the knee were reviewed, who had been admitted to our hospital from October 1996 to November 2002, including 17 patients undergoing the fibular and iliac transplantation with the vessels anastomosed after the extensive excision of the bone tumor. By the surgically-staged manner of Enneking, all the patients were grouped in the stage of I A; by the Campanacci's radioactive image staging, 11 patients were grouped in stage I, 5 in stage II , and 1 in stage III; by the Jaffe's pathological staging, 9 patients were grouped in stage I, 7 in stage II, and 1 in stage III. Of the patients, 9 were treated by the vascularized fibular combined with iliac grafting in the proximal tibia after the tumor extensive resection, and 8 were treated by the distal femur reconstruction by the operation. The following items were also analyzed: postoperative infection, growth of the bone graft, rate of local recurrence, tumor metastasis, and bone death. The function of the knee joint was evaluated.


RESULTS
According the follow-up of the 17 patients for 26-87 months (mean, 54 months), all the bone graft healed well within 75-120 days (mean, 93 days) after operation. Two patients had a local recurrence and 3 had a mildly-narrowed joint. The flexion and extension function of the knee joint recovered, with a range of motion of the reconstructed distal femur of 80 degrees-105 degrees (mean, 96 degrees) while the proximal tibia had a range of motion of 90-120 degrees (mean, 110 degrees). The functional outcome was excellent in 11 patients, good in 3 patients, fair in 1 patient, and bad in 2 patients, with a total satisfactory rate of 82.4%.


CONCLUSIONS
The vascularized fibular combined with iliac grafting after the tumor extensive resection to treat giant cell tumor of the bone around the knee has advantages of complete resection of the tumor and well-restored or reconstructed structure and function of the knee joint.
Li
Dongsheng
D
Department of Bone Tumor, Luoyang Orthopedics Hospital, Luoyang Henan, 471002, PR China. luoyanglds@163.com
Feng
Feng
F
Gu
Jianli
J
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery; D016025:Bone Transplantation; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000098:blood supply / Q000637:transplantation*; D007719:Knee Joint; D008297:Male; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*