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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 4, 531-535.
doi: 10.1302/0301-620X.88B4.17407  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Treatment of local recurrences of giant cell tumour in long bones after curettage and cementing

A SCANDINAVIAN SARCOMA GROUP STUDY

F. Vult von Steyern, MD, PhD, Orthopaedic Surgeon1; H. C. F. Bauer, MD, PhD, Professor of Orthopaedic Oncology2; C. Trovik, MD, PhD, Consultant Orthopaedic Surgeon3; A. Kivioja, MD, MSc, Orthopaedic Surgeon4; P. Bergh, MD, PhD, Orthopaedic Surgeon5; P. Holmberg Jörgensen, MD, DMsc, Consultant Orthopaedic Surgeon6; G. Follerås, MD, Consultant Orthopaedic Surgeon7; and A. Rydholm, MD, PhD, Professor of Orthopaedic Oncology1

1 Department of Orthopaedics, Lund University Hospital, SE-221 85, Lund, Sweden.
2 Department of Orthopaedics, Karolinska Hospital, SE-171 76, Stockholm, Sweden.
3 Department of Orthopaedics, Haukeland University Hospital, NO-5021, Bergen, Norway.
4 Department of Orthopaedics and Traumatology, Helsinki University, Central Hospital, FI-00029, Helsinki, Finland.
5 Department of Orthopaedics, Sahlgrenska Hospital, SE-413 45, Göteborg, Sweden.
6 Department of Orthopaedic Surgery, Århus University Hospital, DK-8000 Århus C, Denmark.
7 Department of Surgery/Orthopaedics, Rikshospitalet University Hospital, Montbello, NO-0310, Oslo 3, Norway.

Correspondence should be sent to Dr F. Vult von Steyern; e-mail: Fredrik.VultvonSteyern{at}skane.se

We retrospectively studied local recurrence of giant cell tumour in long bones following treatment with curettage and cementing in 137 patients. The median follow-up time was 60 months (3 to 166). A total of 19 patients (14%) had at least one local recurrence, the first was diagnosed at a median of 17 months (3 to 29) after treatment of the primary tumour. There were 13 patients with a total of 15 local recurrences who were successfully treated by further curettage and cementing. Two patients with a second local recurrence were consequently treated twice. At the last follow-up, at a median of 53 months (3 to 128) after the most recent operation, all patients were free from disease and had good function.

We concluded that local recurrence of giant cell tumour after curettage and cementing in long bones can generally be successfully treated with further curettage and cementing, with only a minor risk of increased morbidity. This suggests that more extensive surgery for the primary tumour in an attempt to obtain wide margins is not the method of choice, since it leaves the patient with higher morbidity with no significant gain with respect to cure of the disease.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General