Abstract：
INTRODUCTION:Although consensus has been reached regarding the main aspects of intralesional surgery for giant cell tumour of the bone (GCTB), debates continue about the most effective combination of local adjuvants. The purpose of study was to analyze the previous experience and determine the most effective curettage approach for GCTB. METHODS:We summarized the findings from 89 papers published from 1962 to 2020 related to this subject. Database consisted of 137 treated groups that included 6441 patients who underwent different curettage techniques without pre-operative administration of bisphosphonates or RANKL inhibitors. RESULTS:Recurrence rates after simple curettage ranged between 27 and 82% with a median value at 47%. The use of one or two local adjuvants reduced the incidence of recurrences approximately by 50% when compared with simple curettage. High-speed burring combined with chemical adjuvants or followed by poly(methyl methacrylate) cementation with or without bone grafting further improved the local control leading to good and excellent results; however, these were not documented in all studies. Simultaneous use of burring, chemical adjuvants, and cementation, which we named here as combined curettage, allowed to down local relapses to the range of 0-26%, with a median at 11%. Oncologic outcomes after combined curettage are significantly better when compared with simple curettage (p < 0.0001) and other variants of enhancement (p = 0.001). CONCLUSIONS:Combined curettage appears to provide the most potent and comprehensive impact on residual tumour cells located in risk zones. This approach should be considered for locally advanced tumours when function-preserving surgery is planned. Additional comparative studies are required to define the optimal curettage enhancement for each individual patient.
journal_name
Int Orthopjournal_title
International orthopaedicsauthors
Machak GN,Snetkov AIdoi
10.1007/s00264-020-04860-ysubject
Has Abstractpub_date
2020-10-22 00:00:00eissn
0341-2695issn
1432-5195pii
10.1007/s00264-020-04860-ypub_type
杂志文章,评审abstract：PURPOSE:Previous reports revealed a correlation between psychological problems and spinal surgery. There is a lack of knowledge on the effect of anxiety on the percutaneous transforaminal endoscopic discectomy (PTED) outcome at the two year follow-up. The purpose of this study is to investigate changes in anxiety after...
journal_title：International orthopaedics
pub_type： 杂志文章
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journal_title：International orthopaedics
pub_type： 杂志文章
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journal_title：International orthopaedics
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pub_type： 杂志文章,多中心研究
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pub_type： 杂志文章,评审
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pub_type： 杂志文章
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更新日期：2016-01-01 00:00:00
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