Giant Cell Tumour Around Knee Managed by Curettage and Zoledronic Acid with Structural Support by Fibula Cortical Struts
https://doi.org/10.5704/MOJ.2011.008
- Author:
Singaravadivelu V
1
;
Kavinkumar V
1
Author Information
1. Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, India
- Publication Type:Journal Article
- Keywords:
GCT, zoledronic acid, fibula strut, recurrence
- From:Malaysian Orthopaedic Journal
2020;14(No.3):42-49
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Giant cell tumour (GCT) of the bone is a
benign tumour with a high tendency to recur after surgery.
This study aimed to analyse prospectively the rate of local
recurrence following management of giant cell tumours by
curettage, using intravenous zoledronic acid as an adjuvant,
and fibular struts to support the empty cavity after curettage.
Materials and Methods: This study was carried out in ten
cases of biopsy-proven GCTs: five males and five females, in
the age group between 18 and 39 years. All patients were
given three doses of zoledronic acid, one pre-operative and
two post-operative. Extended curettage was done three
weeks after the pre-operative dose of zoledronate. The cavity
was left empty in all the cases. Fibular struts were used to
support the cavity from collapse. Patients were followed-up
for post-operative local recurrence. The functional status of
the patients was assessed during each visit using the
Musculoskeletal Tumour Society (MSTS) score.
Results: There were no recurrences at a follow-up of two
years. All patients had a stable knee and were able to bear
weight fully. The average knee flexion was 75º. The average
MSTS score of the study was 92%.
Conclusion: Extended curettage using hydrogen peroxide,
systemic zoledronic acid adjuvant and leaving the cavity
empty without using cancellous bone graft did not lead to a
recurrence of GCT. Non-vascularised fibular strut provided
adequate support while the cavity left empty after curettage
did not collapse and there was good knee function.
- Full text:16.2020my1109.pdf
