MATERIAL AND METHODS: All patients with biopsy-proven GCT, involving either the distal femur or proximal tibia, and treated with either curettage with bone grafting (CBG), curettage with bone cementation (CBC), or curettage combined with grafting and cementation (the Sandwich technique) were included. They were further classified according to Campanacci grading. Patients were followed for a minimum of two years, and all complications were recorded.
RESULTS: The three groups showed a statistically significant difference in terms of persistent pain after surgery (p=0.03), development of long-term arthritis (p=0.01), as well as overall complications (p=0.005). There was no significant difference in terms of the overall recurrence rate between each group (p>0.05). For Campanacci Grade II lesions, there was a statistically significant difference in terms of local recurrence (p=0.01), with lower recurrence rates observed after cementation procedures.
CONCLUSION: The study indicates that the Sandwich technique was associated with a lower rate of complications compared to CBG or CBC. Patients in the CBG group reported persistent pain, while those in the CBC group exhibited early arthritic changes within five years of the index surgery. Although there was no overall difference in recurrence rates, cementation procedures had a significantly lower rate of recurrence in Campanacci Grade II lesions.