TY - JOUR
T1 - Intralesional curettage for grades II and III giant cell tumors of bone
AU - Lackman, Richard D.
AU - Hosalkar, Harish S.
AU - Ogilvie, Christian M.
AU - Torbert, Jesse T.
AU - Fox, Edward J.
PY - 2005/9
Y1 - 2005/9
N2 - 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).
AB - 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).
UR - http://www.scopus.com/inward/record.url?scp=24344465719&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=24344465719&partnerID=8YFLogxK
U2 - 10.1097/01.blo.0000180051.27961.c3
DO - 10.1097/01.blo.0000180051.27961.c3
M3 - Article
C2 - 16131880
AN - SCOPUS:24344465719
SN - 0009-921X
VL - 438
SP - 123
EP - 127
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
ER -