Have the difficulties and complications of surgical treatment for chondroblastoma of the adjoining knee joint been overestimated?

Abstract

Background and objective Chondroblastoma is difficult to treat as the tumor is surrounded by both articular cartilage and the epiphyseal plate. The differences in joint shape further complicate the problem. This retrospective study evaluates the efficacy of intraregional aggressive curettage and allogeneic bone grafting for treating chondroblastoma of the adjoining knee joint. Methods From February 2010 to February 2017, 36 patients with chondroblastoma of the adjoining knee joint were identified. All patients were treated with intraregional aggressive curettage, phenolization, and allogeneic bone grafting. Follow-up for lesion healing, local recurrence, functional outcomes and secondary osteoarthritis were assessed both clinically and radiologically. Results Thirty-six patients (mean age 17 years) were enrolled with a mean follow-up of 51.8 months (18–98 months). The tumor locations were as follows: distal femur (14), proximal tibia (20), and patella (2). Only 1 patient relapsed, 10 months post-operation. All patients had good bone healing. No knee varus or valgus deformity developed. The mean Musculoskeletal Tumor Society functional score was 28.6 ± 1.1 post-operation. At the last follow-up, secondary osteoarthritis was found in 1 patient, the patient was asymptomatic. Conclusions Intraregional aggressive curettage, phenolization, and allogeneic bone grafting are effective for treatment of chondroblastoma of the adjoining knee joint.

Chondroblastoma of the patella with pathological fracture in an adolescent: a case report

“…The symptoms in many reports include local pain, swelling, joint stiffness and/or effusion, and the development of a limp [3–6, 21–23]. Physical examination may reveal swelling, local tenderness, joint effusion, or local mass.…”

“…Histologically, CB is characterized by round or polyhedral chondroblasts with a central, longitudinal nuclear groove (“coffee bean” nucleus). In the majority of lesions, islands of cartilage or chondroid matrix can be found [6, 21–23]. Edel et al considered that the microscopic appearance of CB can be distinguished from that of other cartillage-containing tumors, such as giant cell tumors of aneurysmal bone cysts [24].…”

“…CB arises from a secondary ossification center in epiphyseal plates and apophyses of a long bone, such as the proximal tibia or femur, distal femur, and proximal humerus [3–5]. The patella is an infrequent site [6].…”

Outcome of Chondroblastoma Treated With Intralesional Curettage and Autogenous Iliac Bone Graft: A Retrospective Study

“…Mashhour and Abdel Rahman [21] preferred aggressive surgical treatment at the time of the rst surgery to prevent recurrence, because re-operation after recurrence might cause more damage on growth plate. Liu Q et al [22] also reported that intraregional aggressive curettage, phenolization, and allogeneic bone grafting were effective for treatment of chondroblastoma with low recurrence. However, lesions extended through the epiphyseal plate or an aggressive curettage does lead to epiphyseal plate injury.…”

Chondroblastoma of the Patella with Secondary Aneurysmal Bone Cyst, an Easily Misdiagnosed Bone Tumor: A Case Report with Literature Review

“…The ratio of CB occurrence between men and women is approximately 3:2. This type of tumors often affect the proximal epiphysis of the femur, humerus, and tibia [2,3] , while those affecting the patella are extremely rare [4,5] . Only a few cases of CB combined with secondary ABC [6] have been reported until date, and they can be easily misdiagnosed as giant cell tumor (GCT) or ABC.…”