Treatment of giant cell tumor of long bones: clinical outcome and reconstructive strategy for lower and upper limbs

• Published in: Orthopedics (Thorofare, N.J.) Vol. 32; no. 7; pp. 491 - 497
• Main Authors: Muramatsu, Keiichi, Ihara, Koichiro, Taguchi, Toshihiko
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.07.2009
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms - surgery; Bones; Calcium phosphates; Clinical outcomes; Female; Fractures; Giant Cell Tumor of Bone - surgery; Humans; Joint replacement surgery; Knee; Lower Extremity - surgery; Magnetic resonance imaging; Male; Middle Aged; Nitrogen; Patients; Reconstructive Surgical Procedures - methods; Skin & tissue grafts; Treatment Outcome; Tumors; Upper Extremity - surgery; Young Adult
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/01477447-20090527-08

Giant cell tumor of bone is a rare and unpredictable lesion. Standard treatment ranges from surgical curettage to wide resection, with reports of varying oncological and functional results. Twenty-three consecutive cases of giant cell tumor of long bones were treated in 10 years. Fifteen men and 8 women had a mean age of 38 years (range, 17-82 years). Average follow-up was 45 months (range, 12-180 months). The most common tumor sites were the proximal tibia (10 cases), distal femur (8), and distal radius (3). All patients remained free of recurrence at the time of final follow-up. Functional outcomes as evaluated by the Musculoskeletal Tumor Society measure were successful, with an average score of 26.6 points (range, 22-30 points). To avoid local recurrence around the knee joint, we recommend radical intralesional curettage with a high-speed drill burr, adjunctive therapy with cryosurgery, and filling with polymethylmethacrylate. Primary total knee arthroplasty is acceptable for older patients. For giant cell tumor of the upper limb or for young patients, biological reconstruction should be applied.