title: No recurrences in selected patients after curettage with cryotherapy for grade I chondrosarcomas.
abstract: BACKGROUND
  The low aggressiveness of Grade I chondrosarcomas is compatible with conservative surgical treatment.
  
  
  OBJECTIVE
  We asked whether combined curettage and cryotherapy would yield low rates of recurrence and whether supplemental internal fixation would retain function with low rates of complications in patients with Grade I central chondrosarcomas of the proximal humerus or distal femur.
  
  
  METHODS
  We retrospectively reviewed 15 patients: nine women and six men with a mean age of 45 years (range, 26-70 years). All patients underwent curettage and cryosurgery through a cortical window; we replaced the window and plated the region with at least three screws beyond the curetted area. None of the patients was lost to followup, and 14 patients (93%) were reexamined by us after a minimum of 5 years (mean, 8 years; range, 5-11 years).
  
  
  RESULTS
  There were no perioperative anesthetic, neurologic, hardware, or healing complications. None of the patients had local recurrence or metastases develop. At last followup, the Musculoskeletal Tumor Society score was 27.9 (range, 22-30) and all patients had resumed their previous activities. No complications were associated with this simplified cryotherapy technique.
  
  
  CONCLUSIONS
  The data confirm the appropriateness of conservative surgery for central low-grade chondrosarcomas of the proximal humerus and distal femur based on a combination of intralesional curettage and cryogenic parietal sterilization. Candidates for this approach should be chosen on the basis of the affected bone site, local extension staging, and clinicopathologic grading. We recommend supplementary internal fixation.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Universitaire de Rennes, 16 Bd de Bulgarie, BP 90347, 35203, Rennes Cedex 2, France.
authors.forename: Badio S
authors.initials: BS
authors.lastname: Souna
authors.forename: Nicolas
authors.initials: N
authors.lastname: Belot
authors.forename: Hélène
authors.initials: H
authors.lastname: Duval
authors.forename: Frantz
authors.initials: F
authors.lastname: Langlais
authors.forename: Hervé
authors.initials: H
authors.lastname: Thomazeau
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D001863:Bone Screws; D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D003475:Curettage; D005260:Female; D005269:Femur / Q000473:pathology / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000473:pathology / Q000601:surgery; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies