Long-term outcome of giant cell tumors of bone around the knee treated by en bloc resection of tumor and reconstruction with prosthesis.
OBJECTIVE
To study the long-term outcomes and complications of giant cell tumors around the knee treated with en bloc resection and reconstruction with prosthesis.


METHODS
From January 1991 to March 2005, 19 patients (11 men, 8 women, average age 35.4 years) were treated in our hospital with en bloc resection and reconstruction with domestic prosthesis (15 hinge knee and 4 rotating-hinge knee). The distal femur was involved in 12 and the proximal tibia in 7 cases. Nine tumors were primary and 10 recurrent. All cases were Campanacci grade III. The affected limb functions were evaluated by the Musculoskeletal Tumor Society scoring system.


RESULTS
All patients underwent operation successfully with no complications. The mean follow-up time was 128.9 months (60 to 216 months). Apart from one patient who underwent amputation because of wound infection two years after reoperation, the range of knee motion of 18 patients was 30°-110°. The mean functional score of the affected limb was 22.7 (15 to 27 points). The length of the lower extremities was equal in nine cases; the affected limb was 2-9 cm shorter in the other ten cases. Prosthesis fracture and loosening developed in one, prosthesis aseptic loosening in three, and delayed deep infection and prosthesis loosening in two cases. The prosthesis loosening rate was 31.6%. One patient developed a proximal femur fracture.


CONCLUSIONS
En bloc resection and reconstruction with prosthesis is a feasible method for treating giant cell tumor of bone around the knee. Complications related to the prosthesis, mainly prosthesis loosening and limb shortening, increase gradually with longer survival time.
Department of Orthopaedics, The General Hospital of Jinan Military Commanding Region, Jinan, China. yxch36@yahoo.com.cn
Xiu-chun
XC
Yu
Ming
M
Xu
Ruo-xian
RX
Song
Zhi-hou
ZH
Fu
Xiao-ping
XP
Liu
D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome