This dealt with the 23 cases of giant cell tumor of femur and tibia who were treated with curettage and cementation of the lesion, over 14 year period. Cement by virtue of it's heat of polymerization may "sterilize" the wall upto 3-5mm in depth.
Authors
adoped cement treatment as an effective adjuvant after intra-lesional surgery(curettage). Curettage was indicated in all stage I lesions ; most stage 2 and some stage 3 lesions, provided the residual bone stock were sufficient to make it
oncologically
and mechanically effective. The follow-up period ranged from 3 to 14 ?ears(oaverage 8 years and 6 monhts). The sites of the lesions were proximal tibia in 8, dital femur in 13, proximal femur in one, and distal tibia in one. Among these cases
3(13.0%)
cases(two grade 1 and one grade 2) of stage II(To : active), and 2(8.7%) of stage III(grade 2) (of stage II(To : active), and 2(8,7%) of stage III(grade 2) (T1 or T2 : aggressive). Utmost attention was paid to nulify or to reduce the local
seeding
of
the tumor cell during aggressive curettage, which was followed by electrical cautery of the cavity wall, and lastly by the cavity obliteration with bone cement None of the cases had lung metastasis. Only in a stage III GCT cases(4.3%) of local
recurrence after curettage and bone and artificial bone graft, recurettage and cementation brought the successful outcome. Through this study, it was reconfirmed that with correct indications the use of cement as a local adjuvant in conjuction
with
curettage was effective method in treating GCT without an side effects.
|