Incidence and progression of osteoarthritis following curettage and cementation of giant cell tumor of bone around the knee: long-term follow-up

Abstract

Background Giant cell tumor of bone (GCTB) is a benign locally aggressive tumor frequently treated with intralesional curettage and cementation. The aim of this study was to investigate the long-term incidence of arthritic changes following curettage and cementation of GCTB around the knee. Materials and methods This study was a retrospective review of patients with GCTB around the knee treated with curettage and cementation with a minimum follow-up of 10 years. The functional results were assessed using the Musculoskeletal Tumor Society (MSTS) score. The arthritic changes were classified using the Kellgren–Lawrence (KL) classification system of osteoarthritis. Results This study included 119 patients, 54 males and 65 females, with a mean age of 29.4 ± 9.2 years. There were 35 (29.4%) patients with pathological fractures. There were 84 (70.6%) patients with de novo lesions and 35 (29.4%) with recurrent lesions. The mean follow-up period was 13.2 ± 3.16 years. The mean MSTS score was 28.5 ± 1.9. Overall, 25 (21%) patients developed variable degrees of arthritis of KL grade 1 (n = 7), KL grade 2 (n = 11), KL grade 3 (n = 4), and KL grade 4 (n = 3). Ten patients showed progression of arthritis during the follow-up period. Age at presentation, gender, presence of pathological fracture, whether the tumor was de novo or recurrent, and tumor location were not associated with arthritis incidence. Conclusions Curettage and cementation can be used safely to treat GCTB around the knee. Arthritis of the knee is a possible complication, but mild grades are expected in most cases. There was no association between arthritis incidence and age, gender, pathological fractures, tumor location, or recurrent tumors. Level of evidence Level IV.

Giant cell tumor of bone and secondary osteoarthritis

“…Rate of osteoarthrosis for patients undergoing surgery involving PMMA is estimated at 12 % in short term follow-up in initial studies describing cementing techniques. Other studies have shown degenerative changes in 26–33 % of patients, and one retrospective study with a minimum follow-up of 10 years reported a rate of 21 %, although only 8 % experienced progression of their arthritis during the follow-up period [ 74 , 76 , 95 , 96 ]. Some studies have shown that PMMA is an independent risk factor for total joint replacement [ 63 ].…”

Knee

“…A group of authors from Burlington (Vermont, USA) attempted a decision tree analysis to address this question, looking at alternative solutions and expected outcomes. 1 The…”

“…This retrospective study based in ShebinEl-Kom (Egypt) sought to provide long-term insights into this issue 1. The investigation focused on determining the frequency of arthriticchanges occurring a decade or more after curettage and cementation of GCTs around the knee.…”