title: Does the addition of cement improve the rate of local recurrence after curettage of giant cell tumours in bone?
abstract: We retrospectively compared the outcome after the treatment of giant cell tumours of bone either with curettage alone or with adjuvant cementation. Between 1975 and 2008, 330 patients with a giant cell tumour were treated primarily by intralesional curettage, with 84 (25%) receiving adjuvant bone cement in the cavity. The local recurrence rate for curettage alone was 29.7% (73 of 246) compared with 14.3% (12 of 84) for curettage and cementation (p = 0.001). On multivariate analysis both the stage of disease and use of cement were independent significant factors associated with local recurrence. The use of cement was associated with a higher risk of the subsequent need for joint replacement. In patients without local recurrence, 18.1% (13 of 72) of those with cement needed a subsequent joint replacement compared to 2.3% (4 of 173) of those without cement (p = 0.001). In patients who developed local recurrence, 75.0% (9 of 12) of those with previous cementation required a joint replacement, compared with 45.2% (33 of 73) of those without cement (p = 0.044).
authors.affiliation: Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK. louie.gaston@nhs.net
authors.forename: C L
authors.initials: CL
authors.lastname: Gaston
authors.forename: R
authors.initials: R
authors.lastname: Bhumbra
authors.forename: M
authors.initials: M
authors.lastname: Watanuki
authors.forename: A T
authors.initials: AT
authors.lastname: Abudu
authors.forename: S R
authors.initials: SR
authors.lastname: Carter
authors.forename: L M
authors.initials: LM
authors.lastname: Jeys
authors.forename: R M
authors.initials: RM
authors.lastname: Tillman
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D003475:Curettage; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019637:Orthopedic Procedures / Q000379:methods*; D011884:Radius / Q000601:surgery; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001843:Bone Cements