gms | German Medical Science

Objectives: Treatment of juxta-articular giant cell tumor of bonearound the knee remains a dilemma. Many authors recommend cementing, others graftingafter extended curettage and others resect and replace by a modular prosthesis. Biological reconstruction remains the corner stone of our believe in treatment of GCT. Is Extended curettage, ISP bone grafting and spanning external fixation a safe and effective procedure for the treatment of juxta articular giant cell tumor of bone around the knee.

Methods: A retrospective review was conducted of giant cell tumor around the knee treated between 2003 and 2016 using the technique of extended curettage through a large bone window ISP, followed by bone grafting and spanning external fixation. Thirty patients with a mean follow-up time of 92 months (range, 70–240 months) were identified.

Results: All 30 patients are continuously free of disease and there were two patients with local recurrences, that treated successfully by extended curettage. A single patient with proximal tibia GCT developed chronic infection. Functional evaluation was performed by ISOLS criteria. The average functional score was 90% (77–100%).The single infectedpatient complained ofchronic pain and demonstrated fusionof the knee joint. All the patients showed union starting from 3 months after surgery with full consolidation 6 months after surgery. The fixator was removed at 5–12 months after surgery. Osteoarthritis of the knee joint was not seen in any of our patients. Five patients had intera-articular fracture of the distal femur at presentation, all healed eventually and did not affect the final results. No stress fracture was seen in any of the patients.

Conclusion: Extended curettage, ISP bone grafting and spanning external fixation is a safe and effective procedure for the treatment of juxta articular giant cell tumor of bone around the knee.