Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anatomy

Background:Giant-cell tumor of the bone (GCTOB) is a relatively uncommon tumor of the bone; represent approximately 21%of benign bone tumors. Approximately 50% of GCTs are located around the knee. The incidence of pathologic fracture at presentation is 11-37%. Objectives: this study aimsto evaluate the functional outcome and the recurrence in patients with giant cell tumors around the knee after extended curettage and cement with or without fixation Patients and methods:We retrospectively reviewed 50 patients with GCT around the knee joint (distal femur and proximal tibia), presented with pathological fractures before surgical intervention. Of the included 50 patients, 29 (58%) underwent extended curette and bone cement, while 21 (42%) underwent extended curette, bone cement and internal fixation. Internal fixation was either with plats and screws [in 14 (28%) patients] or with pins [in 7 (14%) patients]. Burr was used in 45 (90%) patients. Bone graft was used in 8 (16%) patients. Results: The results showed that the primary GCT has better functional outcome than recurrent cases. The use of high speed electric burr gave significant difference in the recurrence rate. The functional outcome in cases treated by PMMA Cement alone is better than that with added osteosynthesisAnd finally the length of the procedure is inversely correlated to functional outcome. Conclusion: Extended curettage with the use of high speed electric burr and filling the cavity with PMMA cement is considered the treatment of choice, in cases which we can achieve sound fracture stability and in cases with limited intraarticular fracture extension Where we can attain anatomical reduction. In other cases in which the fracture is very unstable or there is intrarticular extension which will not be able to be reduced anatomical by the use of cement alone, then further osteosynthesis by locked plate is the treatment of choice with early rehabilitation program

Issued also as CD