Intralesional curettage for grades II and III giant cell tumors of bone.

Abstract:

UNLABELLED:Grade III Campanacci lesions are traditionally treated with wide resections based on their postulated aggressiveness and potential for local recurrence and metastasis. The purpose of this study was to determine if there was a difference in local recurrence rates of Grade II and III lesions treated with intralesional curettage, burring, phenol cauterization, and polymethylmethacrylate application. Sixty-three patients (26 Campanacci Grade II and 37 Grade III lesions) met the inclusion criteria. No pathologic fractures, including intraarticular fractures, were included in this study. Followup averaged 108 months (range, 25-259 months). The overall local recurrence rate was 6% (4 of 63 patients), with no observed difference between Grade II and III lesions. The average Musculoskeletal Tumor Society functional score was 27.9/30 (93%). The mean range of motion of the adjacent joint was 97%. Patients with radiographic signs of osteoarthritis before treatment did not show substantial progression, and only one patient developed radiographic signs of degenerative arthritis postoperatively. Our distal metastatic rate was 3.2%. These data support the use of intralesional curettage and burring with adjuvant phenol and polymethylmethacrylate even in Grade III lesions, in the absence of pathologic fracture, regardless of the presence or extent of extraosseous extension. LEVEL OF EVIDENCE:Therapeutic study, Level III-1 (retrospective cohort). See the Guidelines for Authors for a complete description of levels of evidence.

journal_name

Clin Orthop Relat Res

authors

Lackman RD,Hosalkar HS,Ogilvie CM,Torbert JT,Fox EJ

doi

10.1097/01.blo.0000180051.27961.c3

subject

Has Abstract

pub_date

2005-09-01 00:00:00

pages

123-7

eissn

0009-921X

issn

1528-1132

pii

00003086-200509000-00022

journal_volume

438

pub_type

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