Benign lytic lesions of the femoral neck: mid-term results of extended curettage and sartorius muscle pedicle bone grafting

Kundu, Zile Singh; Gogna, Paritosh; Sangwan, Sukhbir Singh; Garg, Rakesh; Kamboj, Pradeep; Singla, Rohit

doi:10.1007/s00402-013-1687-8

Cited by 7 publications

(13 citation statements)

References 22 publications

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“…The preoperative and postoperative MSTS scores were 80.04% ± 24.09% (6.67%-100.00%) and 93.19% ± 17.39% (16.67%-100.00%), respectively. Curettage is one of the most common treatment options for benign lytic bone tumors and tumorlike lesions [1][2][3][4][17][18][19]. However, after intralesional curettage of these lesions, highspeed burring, electrocautery, phenol, hydrogen peroxide, liquid nitrogen and absolute alcohol are generally advocated by many surgeons as several adjuvant treatment methods to reduce the rate of local recurrence [4,8,20,21].…”

Section: Fig6 Case 18 a 38-year-old Female Originally Was Diagnosedmentioning

confidence: 99%

“…There would be a resultant defect after curettage of a bone tumor, which usually needs to be filled up. Materials that can be used in filling usually are divided in four groups: autografts, allografts, xenografts and synthetic biomaterials [1,4,[6][7][8].…”

Section: Table1．clinical Details Of Patientsmentioning

confidence: 99%

“…Bone cement is one of alternative biomaterials, which has been used for a long time but not biodegradable. It can provide structural support with strong compressive strength that is greater than cancellous bone, but it poorly resists shear and torsion [1,8]. Therefore, if bone cement is used to pack the defects in the bones of lower extremities, there would be high risk of occurring fracture through the tumor site, where shearing and torsional stress always act [8,34].…”

Section: Table1．clinical Details Of Patientsmentioning

confidence: 99%

“…Benign tumors and tumor-like lesions of bone encompass a broad category of miscellaneous conditions, which tend to form osteolytic destruction of bone [1].…”

Section: Introductionmentioning

confidence: 99%

“…Both ends of femur and the proximal end of tibia have been described to be most commonly affected by these lesions [1][2][3][4]. Because osteolytic lesions weaken the bones, pathologic fractures, one of serious consequences, are likely to occur to the involved bones [1,5]. It has been reported that the risk of pathological fracture rises with lesion's size if the peritrochanteric region of femur is affected by osteolytic lesions.…”

Section: Introductionmentioning

confidence: 99%

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Vascularized Fibular Graft Reconstructing Large Bone Defects after Extended Curettage of Osteolytic Lesions in Lower Extremities

2019

ARC Journal of Clinical Case Reports

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Background: Benign lytic lesions of bone encompass a group of neoplasm or disorders of human skeleton. Planning a treatment protocol for patients with osteolyic lesions of lower extremity involves many concerns of different risks. Especially, the reconstruction of large bony defects following surgical resection of the lesions presents a challenge for the operating surgeon. Materials and Methods: Twenty-three cases of benign bone tumors or tumor-like lesions in the lower extremities treated between April 2013 to March 2016 were retrospectively analyzed. Lesion was scooped out with extended curettage technique and the tumor wall was treated by zinc chloride. Vascularized fibular grafting with or without plate fixation were performed to reconstruct bone defect. The patients were followed up and assessed with the MSTS score (Musculoskeletal Tumor Society score) and radiological images. Results: The mean follow-up term is for 43.1 months, ranging from 24 to 77 months. One patient of giant cell tumor developed recurrence at 12-month follow-up, who finally died from lung metastasis. The other 22 patients showed no sign of recurrence. Overall, there was no evidence of avascular necrosis of fibular graft in any case. The average time of bony union between vascularized fibular graft and the receipt site was 4.3 months (rang, 2-7 months). The mean MSTS scores of pre-operation and post-operation were (80.87 ± 23. 49) % and (93.19 ± 17. 39) %, respectively, which showed that the functional outcomes of affected limbs were averagely restored to excellent level at the final follow-up. Conclusions: The outcomes showed that vascularized fibular grafting following extended curettage and zinc chloride treating is a reliable and effective surgical option in the management of benign bone tumors or tumorlike lesions in the lower extremities.

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Section: Fig6 Case 18 a 38-year-old Female Originally Was Diagnosedmentioning

confidence: 99%

Section: Table1．clinical Details Of Patientsmentioning

confidence: 99%

Section: Table1．clinical Details Of Patientsmentioning

confidence: 99%

“…Benign tumors and tumor-like lesions of bone encompass a broad category of miscellaneous conditions, which tend to form osteolytic destruction of bone [1].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Vascularized Fibular Graft Reconstructing Large Bone Defects after Extended Curettage of Osteolytic Lesions in Lower Extremities

2019

ARC Journal of Clinical Case Reports

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Sartorius muscle-pedicle bone graft for osteonecrosis of the femoral head

Chen

Tan

Gao

et al. 2015

International Orthopaedics (SICOT)

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The dilemma of denosumab: Salvage of a femoral head giant cell tumour

Gaston

Puls

Grimer

2014

International Journal of Surgery Case Reports

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INTRODUCTIONDenosumab is a monoclonal RANKL antibody which has been shown to be highly effective in treating giant cell tumour (GCT) of bone. We report on its use as a neo-adjuvant agent to avoid morbid surgery for an adolescent.PRESENTATION OF CASEWe report a case of a15-year old female with a Campanacci 3 GCT involving the femoral head and neck.DISCUSSIONTo preserve bone stock and avoid an outright hip replacement, the patient was given denosumab pre-operatively to consolidate the tumour. After receiving 6 months of treatment, a rim of cortical bone had developed to allow an extended curettage of the tumour to be performed without fear of collapse of the articular surface.CONCLUSIONThis is the first reported case of the use of denosumab in GCT of the femoral head and neck. We describe our experience in the neo-adjuvant use of denosumab and offer suggestions for future use. Further studies will be needed to see if denosumab has a role in conventional GCT and whether it can lead to a lowering of local recurrence rates.

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Benign lytic lesions of the femoral neck: mid-term results of extended curettage and sartorius muscle pedicle bone grafting

Abstract: Sartorius muscle pedicle bone grafting using anterior approach is a good and reliable option in patients presenting with benign lytic lesion in the neck of femur.

Cited by 7 publications

References 22 publications

Vascularized Fibular Graft Reconstructing Large Bone Defects after Extended Curettage of Osteolytic Lesions in Lower Extremities

Vascularized Fibular Graft Reconstructing Large Bone Defects after Extended Curettage of Osteolytic Lesions in Lower Extremities

Sartorius muscle-pedicle bone graft for osteonecrosis of the femoral head

The dilemma of denosumab: Salvage of a femoral head giant cell tumour

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