title: Curettage with cement augmentation of large bone defects in giant cell tumors with pathological fractures in lower-extremity long bones.
abstract: BACKGROUND
  Thorough curettage and cement augmentation is the procedure of choice for treating giant cell tumor lesions, particularly those associated with large defects. Its association with pathological fractures has not been studied to a great extent, although a pathological fracture following a giant cell tumor is not a contraindication to treatment by curettage and cementation. We present our experience of bone cementation following intralesional curettage for treatment of giant cell tumors of the long bones of lower limbs with associated pathological fractures.
  
  
  METHODS
  A total of 38 patients who had undergone a procedure in the weight-bearing long bones of lower limbs were included in the study. The age of the patients ranged from 18-79 years with a mean age of 38.57 years. The average follow-up was 102.42 months (8.5 years) ranging from 60-186 months (5-15.5 years). Results were based on serial radiographs showing consolidation of the lesion along with a subjective clinical examination and Enneking functional evaluation noted in the patient's records.
  
  
  RESULTS
  Approximately 76 % of the lesions occurred around the knee. The results were graded as excellent (72 %), good (12.82 %) fair (10.25 %) and poor (5.12 %). Four cases developed a recurrence. Apart from a few documented complications, the lesions showed good consolidation and healed well.
  
  
  CONCLUSIONS
  Giant cell tumors of the long bones of lower limbs with an associated pathological fracture at diagnosis can be managed with thorough curettage and cement augmentation of the bone defect with a satisfactory outcome.
  
  
  METHODS
  Level IV.
authors.affiliation: Mahatma Gandhi Medical College and Hospital, Jaipur, India.
authors.forename: Som P
authors.initials: SP
authors.lastname: Gupta
authors.affiliation: S.M.S. Medical College and Attached Hospitals, Jaipur, India. gaurav_ortho@yahoo.com.
authors.forename: Gaurav
authors.identifier: http://orcid.org/0000-0003-3569-7461
authors.initials: G
authors.lastname: Garg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D003475:Curettage; D005260:Female; D005266:Femoral Neoplasms / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005598:Fractures, Spontaneous / Q000473:pathology / Q000601:surgery*; D018212:Giant Cell Tumor of Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013977:Tibia / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements
keywords: Cement augmentation; Curettage; Giant cell tumors; Pathological fractures