Resection-reconstruction arthroplasty for giant cell tumor of distal radius

Saikia, Kabul C; Borgohain, Munin; Bhuyan, Sanjeev Kumar; Goswami, S. C.; Bora, Anjan; Ahmed, Firoz

doi:10.4103/0019-5413.65134

Cited by 35 publications

(49 citation statements)

References 30 publications

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“…(8,6,9,10,11,12,7,13,14,17,15,18) The recurrence rate has been reported to be 0% or 5 to 25%. (5,13,19) In our study there was no recurrence. In some series subluxation of wrist has been reported.…”

Section: Discussionsupporting

confidence: 51%

Evaluation of Results of Wide Resection and Reconstruction Using Non - Vascularised Ipsilateral Proximal Fibula for Giant Cell Tumor of Lower End of Radius

Sujai¹,

Jayakrishnan²,

Jayaswal³

et al. 2015

jemds

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BACKGROUND: Giant cell tumour of bone can occur at lower end of Radius and it is the third common site. The tumour has to be treated properly to prevent recurrence. Various methods of treatment are available and resection and reconstruction using ipsilateral upper end of fibula is one of the methods available. METHODS: The patients who had GCT lower end of Radius and attended the hospital for treatment were taken in this retrospective study. The tumour was evaluated clinically and with X-ray and MRI. The tumour was confirmed by FNAC or biopsy. The tumour was resected and reconstruction of the Radius was done using non-vascularised ipsilateral fibula. RESULTS: There were ten patients in this study, six males and four females with age varying from 25 to 41 years and follow up period varied from 36 to 60 months. The results were assessed by musculoskeletal tumour society score. Average grip strength was 65% of normal and over all functional range combined movements was 155 degrees which is comparable to published reports. The result was good in eight patients and in two cases there was mild subluxation of wrist joint which was graded as fair.. There was no recurrence of tumour. CONCLUSIONS: GCT of lower end of Radius treated with resection and reconstruction using nonvacularised ipsilateral fibula gives good result cosmetically and functionally.

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Section: Discussionsupporting

confidence: 51%

Evaluation of Results of Wide Resection and Reconstruction Using Non - Vascularised Ipsilateral Proximal Fibula for Giant Cell Tumor of Lower End of Radius

Sujai¹,

Jayakrishnan²,

Jayaswal³

et al. 2015

jemds

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“…In contrast, in adults, the absence of joint-surface remodeling results in radiocarpal joint incongruity and consequently osteoarthritis and movement limitation [22,29]. The average ROM of the wrist after reconstruction using the fibular autograft has been reported as 20°-38°flexion, 20°-50°extension, 30°-80°pronation, and 15°-52°supination [21,28,30]. Despite osteoarthritic changes and decreased ROM, most patients in those studies [21,28,30] had little limitation in daily activities.…”

Section: Discussionmentioning

confidence: 99%

“…The average ROM of the wrist after reconstruction using the fibular autograft has been reported as 20°-38°flexion, 20°-50°extension, 30°-80°pronation, and 15°-52°supination [21,28,30]. Despite osteoarthritic changes and decreased ROM, most patients in those studies [21,28,30] had little limitation in daily activities. However, the technique has been associated with potential complications such as nonunion, delayed union of the graft, collapse of the grafted fibular head and donor-site morbidity [28,31].…”

Section: Discussionmentioning

confidence: 99%

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What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Wang

Liu

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Purpose A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist after en bloc resection warrant study. Questions We asked: (1) What are the functional outcomes after en bloc resection and reconstruction of the wrist with a unipolar prosthesis in patients with Grade III GCT of the distal radius? (2) What complications occur with use of a unipolar prosthesis in these patients? (3) What are the oncologic outcomes with using en bloc resection and reconstruction with a custom unipolar wrist hemiarthroplasty for Grade III GCTs of the distal radius? Methods We retrospectively analyzed 10 patients with Campanacci Grade III GCTs of the distal radius treated by a unipolar prosthesis after wide resection of the tumor between January 2008 and October 2013. During that period, all patients at our medical group who presented with a Grade III GCT of the distal radius were treated with wide resection and reconstruction using a custom unipolar implant. Pre-and postoperative pain at rest were assessed according to a 10-cm VAS score. The functional outcomes of the wrist were assessed using the modified Mayo wrist score, and the degenerative changes were evaluated radiographically by a new rating system based on the Knirk and Jupiter scale. We also analyzed tumor recurrence, metastases, and complications associated with the reconstruction procedure. All patients were available for followup at a mean of 52 months (range, 24-90 months). Results Although the complication rate associated with prosthetic arthroplasty was relatively high (six of 10), none of our patients experienced severe complications. Two patients reported having occasional pain of the involved wrist at the time of final followup (VAS, preoperative versus postoperative: 0 versus 3; 5 versus 2, respectively). The mean modified Mayo wrist score was 68 (range, 45-90). Degenerative changes were found in three wrists (Grade 1, two patients; Grade 2, one patient). Aseptic loosening occurred in one patient and wrist subluxation occurred in two patients. Lung metastases or local tumor recurrence were not observed. Conclusions Because of the proportion of patients who had complications and progressive degeneration with this approach, we recommend first exploring alternatives to reconstruction with custom unipolar wrist hemiarthroplasty after resection of Grade III GCTs of the distal radius, such as fibular autografting. However, this technique provides an alternative for patients with concerns regarding possible morbidity associated with autografting, and for situations when allograft is not available.

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“…Hence, reconstruction of the distal radius is a challenge with regard to regaining normal function in the hand with minimal complications. A number of studies have reported on the reconstruction of segmental distal radial defects after tumour resection by using a non-vascularised or vascularised autogenous fibular graft; the reconstruction procedures have mainly included arthroplasty [2,4,[17][18][19][20][21], partial wrist arthrodesis [3,22,23] and complete wrist arthrodesis [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Partial wrist arthrodesis versus arthroplasty for distal radius giant cell tumours

Zhu

Zhang

Zhao

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the clinical efficacy of using the proximal fibular graft for partial wrist arthrodesis or arthroplasty after the resection of giant cell tumours of the distal radius. Methods Between February 2006 and August 2010, 14 patients (seven males, seven females; average age, 35.7 years) with grade II and III giant cell tumours of the distal radius were treated by tumour resection and autologous proximal fibular grafts to reconstruct the wrist in our hospital. Seven patients each were treated by wrist arthroplasty and partial wrist arthrodesis, and were followed up for 2.2-6.8 years (average, 3.9 years).

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Resection-reconstruction arthroplasty for giant cell tumor of distal radius

Cited by 35 publications

References 30 publications

Evaluation of Results of Wide Resection and Reconstruction Using Non - Vascularised Ipsilateral Proximal Fibula for Giant Cell Tumor of Lower End of Radius

Evaluation of Results of Wide Resection and Reconstruction Using Non - Vascularised Ipsilateral Proximal Fibula for Giant Cell Tumor of Lower End of Radius

What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Partial wrist arthrodesis versus arthroplasty for distal radius giant cell tumours

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