title: Curettage and reconstruction by the sandwich technique for giant cell tumours around the knee.
abstract: OBJECTIVE
  To evaluate outcomes of 36 patients who underwent curettage, use of phenol, and reconstruction using the sandwich technique for giant cell tumour (GCT) of bone around the knee.
  
  
  METHODS
  22 women and 14 men aged 19 to 46 (mean, 29.6) years underwent intralesional curettage, use of phenol, and reconstruction using the sandwich technique for GCT of the proximal tibia (n=23) or distal femur (n=13). Two of the cases were recurrences. Two, 18, and 16 tumours were classified as grade I, grade II, and grade III, respectively. Five of the grade III tumours were associated with an extra-articular pathological fracture. Patients underwent intralesional curettage, use of phenol, and reconstruction with allograft, gel foam, and cement (the sandwich technique). Pathological fractures were fixed with plates. Functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) score.
  
  
  RESULTS
  The mean follow-up period was 5 (2.5-11) years. The mean MSTS score was 27.7 out of 30 (standard deviation, 3; range, 16-30). One patient with a grade III tumour in the proximal tibia had a recurrence detected elsewhere after 3 years. Her MSTS score at 2 years was 26. No patient had malignant transformation.
  
  
  CONCLUSIONS
  Intralesional curettage, use of phenol, and reconstruction with allograft, gel foam, and cement (the sandwich technique) for GCT of bone achieved good functional outcome and a low recurrence rate.
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Saibaba
authors.forename: Devendra Kumar
authors.initials: DK
authors.lastname: Chouhan
authors.forename: Vishal
authors.initials: V
authors.lastname: Kumar
authors.forename: Mandeep Singh
authors.initials: MS
authors.lastname: Dhillon
authors.forename: Sreekanth Reddy
authors.initials: SR
authors.lastname: Rajoli
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D003475:Curettage; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery; D005870:Giant Cell Tumors / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007717:Knee; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery; D019800:Phenol / Q000008:administration & dosage; D011859:Radiography; D019651:Plastic Surgery Procedures; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents; D019800:Phenol
keywords: curettage; giant cell tumor of bone; phenol