Joint salvage and biological repair of massive-cavity bone defects after extensive curettage of giant cell tumor around the knee with vascularized fibular autograft and cancellous allograft

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> Treatment of giant cell tumor (GCT) around knee remains challenging because GCT is prone to recurrence and metastasis. Herein, we reported on our clinical experience with knee joint salvage and biological repair of massive-cavity bone defects after extensive curettage of GCT around the knee with vascularized fibular autograft and cancellous allograft in 12 patients.<jats:bold>Methods: </jats:bold>All the patients underwent clinical evaluation, plain radiography and/or magnetic resonance imaging (MRI) of the knee right after admission. Their joint function was preserved, and the massive-cavity bone defects were repaired by vascularized fibular autografts and cancellous allograft after extensive curettage of GCT around the knee. All the patients were evaluated through clinical examinations, plain radiography of the knee and chest, and Musculoskeletal Tumor Society (MSTS) scores of the lower extremity in the follow-ups.<jats:bold>Results:</jats:bold> The follow-up duration ranged from 1.5 years to 12.0 years (mean 4.2 years). There were no local recurrences or lung metastasis in any of the 12 patients at the last follow-up. Ten patients had no pain or experienced occasional pain, and nine were able to resume their previous work. The mean range-of-motion of knee flexion was 117°, and the extension was -6°. The mean MSTS score was 24.7, and a total of 10 patients had excellent or good MSTS scores. <jats:bold>Conclusion:</jats:bold> Knee joint salvage and biological repair of massive-cavity bone defects could be achieved after extensive curettage with vascularized fibular autograft and cancellous allograft in patients with GCT around the knee.</jats:p>