Results of Cement versus Bone Graft Reconstruction after Intralesional Curettage of Bone Tumors in the Skeletally Immature Patient

Wallace, Matthew T.; Henshaw, Robert M.

doi:10.1097/bpo.0b013e31829b2f61

Cited by 25 publications

(21 citation statements)

References 6 publications

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“…Ozaki et al reported lower recurrence with curettage and cementing compared to curettage and grafting alone, 17 and 37 %, respectively [44]. In a retrospective comparative study examining the effect of cement versus bone grafting in benign pediatric bone lesions, Wallace et al reported similar complication and recurrence rates, and Mankin et al also reported similar rates of recurrence when using bone graft or cement [19,43]. The application of PMMA to the predominantly pediatric population that is afflicted with ABC warrants consideration with regard to its long-term effects: PMMA is biologically inert without the potential for osseous incorporation, has no growth potential, can lead to stress shielding, thereby increasing the risk of future pathologic fracture, and as a foreign body, may act as a nidus for infection.…”

Section: Cementmentioning

confidence: 52%

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Current management of aneurysmal bone cysts

Park

Yang

Sheppard

et al. 2016

Curr Rev Musculoskelet Med

190

259

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Aneurysmal bone cysts (ABCs) are benign bone lesions arising predominantly in the pediatric population that can cause local pain, swelling, and pathologic fracture. Primary lesions, which constitute roughly two thirds of all ABCs, are thought to be neoplastic in nature, with one third of ABCs arising secondary to other tumors. Diagnosis is made with various imaging modalities, which exhibit characteristic features such as Bfluid-fluid levels,^although biopsy is critical, as telangiectatic osteosarcoma cannot be excluded based on imaging alone. Currently, the standard of care and most widely employed treatment is intralesional curettage. However, tumor recurrence with curettage alone is common and has driven some to propose a multitude of adjuvants with varying efficacy and risk profiles. Historically, therapies such as en bloc resection or radiation therapy were utilized as an alternative to decrease the recurrence rate, but these therapies imposed high morbidity. As a result, modern techniques now seek to simultaneously reduce morbidity and recurrence, the pursuit of which has produced preliminary study into minimally invasive percutaneous treatments and medical management.

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Section: Cementmentioning

confidence: 52%

“…Similarly, polymethylmethacrylate (PMMA) cement in pediatric benign bone lesions can provide immediate stabilization for the resultant cavity, and it can act as a recurrence reducing adjuvant through its exothermic effect as the cement hardens [43]. With regard to reduction of recurrence, the evidence is mixed on the efficacy of cement.…”

Section: Cementmentioning

confidence: 99%

Current management of aneurysmal bone cysts

Park

Yang

Sheppard

et al. 2016

Curr Rev Musculoskelet Med

190

259

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“…The effect of the cement on the physes in patients with an immature skeleton is controversial. 15 Wallace and Henshaw 16 argued that cementing had no negative effect, whereas Gasden et al has reported its undesirable outcomes. 17 The use of high-speed burring may be limited in patients with an immature skeleton as it may increase the damage to the physis or destruct the cartilage in the areas with subchondral bone loss.…”

Section: Discussionmentioning

confidence: 99%

Chondroblastoma: An evaluation of the recurrences and functional outcomes following treatment

Özer¹,

Arıkan²,

Gur³

et al. 2018

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveChondroblastoma is a benign aggressive tumor which needs surgical treatment and has a recurrence rate up to 35%. Extended (aggressive) curettage is the mainstay of treatment and local adjuvants have been reported to decrease the recurrence rate.MethodsThe recurrence rates and the functional results of 14 patients who were treated in our institution and 2 other patients who were treated elsewhere between the years 2004–2016 were evaluated. Seventeen cases (13 male, 3 female; mean age: 17.1 [range: 13 to 32] years) who had been diagnosed, treated and followed up in our hospital between 2004 and 2016 were evaluated in terms of recurrence rates and functional outcomes. The average follow-up period was 41.6 (range: 12 to 132) months.ResultsFive cases of recurrence were observed. Two cases had undergone their primary treatment in another institution. Seven cases were performed curettage alone whereas nine others were administered adjuvant treatments. One of the five recurrence patients was advised to undergo disarticulation. Another was treated with curettage and grafting and the remaining three patients with curettage and cementing. No recurrence was observed in their follow-up period. Their mean MSTS score was 27.3 (range: 4 to 30) over a maximum of 30 points and their functional results were good.ConclusionChondroblastoma is a tumor with high recurrence rates in the post-treatment period. However, good functional outcomes can be achieved with early diagnosis and appropriate treatment even after recurrence.Level of evidence: Level IV, therapeutic study.

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“…Cryotherapy includes the use of liquid or aerosolised nitrogen that creates freezing temperatures that leads to a cytotoxic effect on the ABC lesion .Cryotherapy is done following curettage of the lesion .Cryotherapy though has a low recurrence rate ,is still not used widely as it has often led to complications like postoperative fracture ,skin necrosis and wound infection [1,4] . Polymethylmethacrylate (PMMA) cement is a biologically inert substance that helps in stabilisation of cavity in paediatric bone lesion and also as a recurrence reducing adjuvant through its exothermic reaction [5] . But PMMA also increases the risk of pathological fracture since it lacks the potential for osseous incorporation and has no growth potential.…”

Section: Discussionmentioning

confidence: 99%