Giant-cell tumour of the knee: the condition of the cartilage after treatment by curettage and cementing.
We reviewed nine patients at a mean period of 11 years (6 to 16) after curettage and cementing of a giant-cell tumour around the knee to determine if there were any long-term adverse effects on the cartilage. Plain radiography, MRI, delayed gadolinium-enhanced MRI of the cartilage and measurement of the serum level of cartilage oligomeric matrix protein were carried out. The functional outcome was evaluated using the Lysholm knee score. Each patient was physically active and had returned to their previous occupation. Most participated in recreational sports or exercise. The mean Lysholm knee score was 92 (83 to 100). Only one patient was found to have cartilage damage adjacent to the cement. This patient had a history of intra-articular fracture and local recurrence, leading to degenerative changes. Interpretation of the data obtained from delayed gadolinium-enhanced MRI of the cartilage was difficult, with variation in the T1 values which did not correlate with the clinical or radiological findings. We did not find it helpful in the early diagnosis of degeneration of cartilage. We also found no obvious correlation between the serum cartilage oligomeric matrix protein level and the radiological and MR findings, function, time after surgery and the age of the patient. In summary, we found no evidence that the long-term presence of cement close to the knee joint was associated with the development of degenerative osteoarthritis.
von Steyern
F Vult
FV
1Department of Orthopaedics, Centre for Medical Imaging and Physiology, Lund University Hospital, Lund, Sweden.
Kristiansson
I
I
Jonsson
K
K
Mannfolk
P
P
Heinegård
D
D
Rydholm
A
A
D000293:Adolescent; D000328:Adult; D018286:Carcinoma, Giant Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D064236:Cartilage Oligomeric Matrix Protein; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology; D002484:Cementation / Q000379:methods; D003475:Curettage / Q000379:methods*; D016326:Extracellular Matrix Proteins / Q000097:blood; D005260:Female; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D064235:Matrilin Proteins; D011859:Radiography; D016896:Treatment Outcome
D064236:Cartilage Oligomeric Matrix Protein; D016326:Extracellular Matrix Proteins; D006023:Glycoproteins; D064235:Matrilin Proteins; C577553:TSP5 protein, human