Cryosurgery and impaction subchondral bone graft for the treatment of giant cell tumor around the knee. 2009

Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
Department of Orthopaedic Surgery, Ain Shams University, Cairo, Egypt.

Giant cell tumors are neoplasms of mesenchymal stromal cells with varied manifestations. There is no uniform accepted treatment protocol for these tumors. Curettage, although an accepted method of treatment, carries a high local recurrence rate. Adjuvant therapies including high-speed burr debridement, cryotherapy, and phenol treatment have been advocated to reduce local recurrence. We have used these adjuvants to determine if improved cure rate with improved outcomes could be attained with regard to local tumor control and functional outcome. Twenty-eight cases of proven giant cell tumors of the distal femur and proximal tibia were included in this prospective case series. The lesions were at the upper tibia in 14 cases and the lower femur in 14 patients. The patients were evaluated clinically, radiologically, and by histological examination. Companacci grading and Enneking staging were determined. The treatment was done in the following steps: Curettage and further debridement with a high-speed burr, cryotherapy, impaction of the cavity with subchondral iliac crest bone graft, and, finally, cementation with or without internal fixation. Functional evaluation was done by Enneking's system. The follow-up time was between 24-40 months with a mean of 34 months. The functional results of the procedure were rated as good to excellent with a mean of 93.9%. This technique has the advantages of joint preservation, excellent functional outcome, and low recurrence rate when compared with other treatment modalities. For these reasons, it is recommended as an adjuvant to curettage for most giant cell tumors of bone.

UI MeSH Term Description Entries

Related Publications

Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
April 1997, Zhonghua yi xue za zhi = Chinese medical journal; Free China ed,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
November 2018, Medicine,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
September 2012, Journal of the Medical Association of Thailand = Chotmaihet thangphaet,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
February 1979, Chinese medical journal,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
January 2016, Pakistan journal of medical sciences,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
April 2007, Indian journal of orthopaedics,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
January 2017, The journal of knee surgery,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
January 2017, Revista brasileira de ortopedia,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
August 2013, Chinese medical journal,
Mohamed Abdelrahman, and Ayman Abdelaziz Bassiony, and Hisham Shalaby, and Mohamed Kamal Assal
June 2020, Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery,
Copied contents to your clipboard!