MyMedR

Fulltext Knee arthrodesis with interlocking nail after excision of giant cell tumour of the distal femur

Yeow C, Chin CH, Ong PH

Med J Malaysia, 1995 Dec;50(4):414-6.

Giant cell tumour of bone occurring around the knee is fairly common and can be difficult to manage. We report a case of such tumour involving the distal femur which was successfully treated with complete excision followed by arthrodesis of the knee with a long interlocking intramedullary nail.

Matched MeSH terms: Giant Cell Tumor of Bone/surgery*

Reconstruction of large sacral defects following tumour resection: a report of two cases

Cheong YW, Sulaiman WA, Halim AS

J Orthop Surg (Hong Kong), 2008 Dec;16(3):351-4.

PMID: 19126905

Sacral tumours often present surgical resection and reconstruction challenges. Wide resections result in large sacral defects and neoadjuvant radiotherapy impairs wound healing. The wounds need to be covered with bulky, well-vascularised, healthy tissues. We present 2 cases where large sacral defects were reconstructed following tumour resection. Both defects were reconstructed with inferiorly based, transpelvic, pedicled vertical rectus abdominis myocutaneous flaps. This is a robust flap and carries a well-vascularised muscle bulk and skin paddle. The donor site is distant from the lesion site and is thus unaffected by both the resection and radiotherapy. This is a useful flap for reconstructing large sacral defects.

Matched MeSH terms: Giant Cell Tumor of Bone/surgery*

Fulltext Resection arthrodesis for primary bone tumour about the knee

Kwan MK, Ng ES, Penafort R, Saw A, Sengupta S

Med J Malaysia, 2005 Jul;60 Suppl C:66-71.

PMID: 16381287 MyJurnal

Bone defect following en bloc resection of primary bone tumor around the knee can be reconstructed by allograft or prothesis or combination of both. Resection-arthrodesis is an alternative option for young vigorous patients facing circumstances of financial constrain or limited supply of allograft. This study was undertaken to determine the outcome and complications associated with resection-arthrodesis of 22 primary bone tumors (13 giant cell tumors and 9 osteosarcomas) around the knee treated between 1990 and 2003 at the University Malaya Medical Center. The mean follow-up was 6 years (range 1-13 years). hree patients with osteosarcoma died of lung metastasis, 3 required above knee amputation and 2 defaulted follow-up. Local complications of the procedure include infection in 8 cases (36.4%), non-union 7 (31.8%) and mal-union. Of 14 patients who returned for final evaluation, 79.8% had satisfactory outcomes according to the Musculoskeletal Tumor Society grading system. In conclusion, resection-arthrodesis of the knee is a viable treatment option for selected patients with primary bone tumor around the knee, and good functional outcome can be expected in the presence of short-term local complications.

Matched MeSH terms: Giant Cell Tumor of Bone/surgery*

Giant cell tumour of bone with late presentation: review of treatment and outcome

Ng ES, Saw A, Sengupta S, Nazarina AR, Path M

J Orthop Surg (Hong Kong), 2002 Dec;10(2):120-8.

PMID: 12493923

To review cases of giant cell tumour of bone or osteoclastoma managed at the University Malaya Medical Center, University of Malaya, Kuala Lumpur, from January 1990 to December 1999.

Matched MeSH terms: Giant Cell Tumor of Bone/surgery*

Retrospective cohort study of 68 sacral giant cell tumours treated with nerve-sparing surgery and evaluation on therapeutic benefits of denosumab therapy

Lim CY, Liu X, He F, Liang H, Yang Y, Ji T, et al.

Bone Joint J, 2020 Feb;102-B(2):177-185.

PMID: 32009426 DOI: 10.1302/0301-620X.102B2.BJJ-2019-0813.R1

AIMS: To investigate the benefits of denosumab in combination with nerve-sparing surgery for treatment of sacral giant cell tumours (GCTs).

METHODS: This is a retrospective cohort study of patients with GCT who presented between January 2011 and July 2017. Intralesional curettage was performed and patients treated from 2015 to 2017 also received denosumab therapy. The patients were divided into three groups: Cohort 1: control group (n = 36); cohort 2: adjuvant denosumab group (n = 9); and cohort 3: neo- and adjuvant-denosumab group (n = 17).

RESULTS: There were 68 patients within the study period. Six patients were lost to follow-up. The mean follow-up was 47.7 months (SD 23.2). Preoperative denosumab was found to reduce intraoperative haemorrhage and was associated with shorter operating time for tumour volume > 200 cm3. A total of 17 patients (27.4%) developed local recurrence. The locoregional control rate was 77.8% (7/9) and 87.5% (14/16) respectively for cohorts 2 and 3, in comparison to 66.7% (24/36) of the control group. The recurrence-free survival (RFS) rate was significantly higher for adjuvant denosumab group versus those without adjuvant denosumab during the first two years: 100% vs 83.8% at one year and 95.0% vs 70.3% at two years. No significant difference was found for the three-year RFS rate.

CONCLUSION: Preoperative denosumab therapy was found to reduce intraoperative haemorrhage and was associated with shorter operating times. Adjuvant denosumab was useful to prevent early recurrence during the first two years after surgery. Cite this article: Bone Joint J 2020;102-B(2):177-185.

Matched MeSH terms: Giant Cell Tumor of Bone/surgery*

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