Sandwich reconstruction technique for subchondral giant cell tumors around the knee

Banerjee, Samik; Sabui, Kanchan Kumar; Chatterjee, Rupak; Das, Abhishek; Mondal, Jayati; Pal, Dilip Kumar

doi:10.1097/bco.0b013e3182640f1a

Cited by 5 publications

(10 citation statements)

References 29 publications

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“…39 In a series of 12 patients with GCT of distal femur managed by sandwich technique, Banerjee et al reported excellent outcome with a mean MSTS score of 26, which is comparable to our series. 40 Sandwich technique allows joint preservation with morselized allograft/autograft, which is shown to incorporate and remodel providing adequate subchondral bone stock, preventing damage to the articular cartilage by thermal and direct effect of cement. 7,35,41 In case of recurrence, during removal of the cement, the incorporated subchondral bone prevents damage to the articular cartilage and also makes up for subsequent joint reconstruction, if required.…”

Section: Discussionmentioning

confidence: 99%

Joint Salvage Using Sandwich Technique for Giant Cell Tumors around Knee

et al. 2014

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The most common site for giant cell tumors (GCT) is knee, where the tumor characteristically extends right up to the subarticular bone plate. Extensive curettage with preservation of the joint should be done wherever possible. The alternatives for filling the void left after curettage are either bone graft or bone cement. Sandwich technique uses the advantages of both, taking care to prevent damage to articular cartilage. This study was done to evaluate the results of sandwich technique in tumors around the knee joint. It was a prospective study of 26 consecutive patients (15 females and 11 males) with Campanacci grade II and grade III GCT around the knee, which qualified the inclusion criterion and underwent knee reconstruction with sandwich technique, after extended curettage of the tumor. The mean age of the patients at the time of surgery was 32.73 ± 11.30 years (range, 18-62 years), and the mean follow-up was 3.87 ± 1.26 years (range, 6.5-2 years). At final follow-up, the functional evaluation was done using Musculoskeletal Tumor Society (MSTS) score and measuring range of motion around the knee. Three patients had recurrence of tumor; in one case, we were able to salvage the joint and repeat sandwich surgery was performed, and in the other two cases, the joint was breached; therefore, we resorted to resection arthrodesis. At final follow-up, the mean functional arc of motion around the knee and the mean MSTS score in patients without arthrodesis was 123.52 ± 10.21 degrees (range, 100-130 degrees) and 27.04/30, respectively; all patients were able to do their activities of daily living with ease. Sandwich technique is a good reconstruction procedure in GCT around knee joint with good survival rate, minimal complications, and good functional outcome.

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Section: Discussionmentioning

confidence: 99%

Joint Salvage Using Sandwich Technique for Giant Cell Tumors around Knee

et al. 2014

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“…Therefore, extensive curettage may be more suitable for reducing local tumor recurrence and knee salvage, especially when using high-speed burr for complete removal of GCT during curettage surgery 24 . Actually, extensive curettage has already been shown to have successful outcomes in the prevention of GCT recurrence 25 …”

Section: Discussionmentioning

confidence: 99%

Joint Salvage and Biological Repair of Massive-Cavity Bone Defects After Extensive Curettage of Campanacci Grade II or III Giant Cell Tumor Around the Knee With Vascularized Fibular Autograft and Cancellous Allograft

et al. 2021

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Objective The aim of the study was to report the clinical outcomes of repair of massive-cavity bone defects after extensive curettage of Campanacci grade II or III giant cell tumor (GCT) around knee with vascularized fibular autograft and cancellous allograft. Methods There were 12 consecutive patients with Campanacci grade II or III GCT around knee treated in our department between 2004 and 2016. All the patients underwent clinical evaluation, plain radiography, and/or magnetic resonance imaging of the knee right after admission. To preserve their knee function, we repaired the massive-cavity bone defects after extensive curettage of GCT by vascularized fibular autografts and cancellous allograft. 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. Results The follow-up ranged from 1.5 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 9 were able to resume their previous work. The mean range of motion of knee flexion was 117 degrees, and the extension was −6 degrees. The mean MSTS score was 24.7, and a total of 10 patients had excellent or good MSTS scores. Conclusions It is reliable to achieve knee joint salvage and repair massive-cavity bone defects after extensive curettage with vascularized fibular autograft and cancellous allograft in patients with Campanacci grade II or III GCT around the knee.

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“…Vascularized bula can repair massive-cavity bone defects and save knee joint Many reconstruction procedures, including sandwich technique, arthroplasty, osteoarticular allograft, allograft arthrodesis, and vascularized or non-vascularized bular autograft with or without arthrodesis have been proposed after wide resection of GCT around the knee [3,4,[25][26][27].…”

Section: Extensive Curettage Can Reduce the Risk Of Recurrencementioning

confidence: 99%

“…Sandwich technique with extensive curettage has shown to prevent tumor recurrence and lead to satisfactory knee salvage [25]. However, since the sandwich technique requires PMMA, which cannot repair bone defects biologically and may lead to thermal injuries, it may not be the optimal method for all GCT around the knee, especially in young and active patients [5,[28][29][30][31].…”

Section: Extensive Curettage Can Reduce the Risk Of Recurrencementioning

confidence: 99%

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

Yang

Gao

Wang

et al. 2020

Preprint

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Abstract Background: 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.Methods: 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.Results: 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. Conclusion: 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.

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Sandwich reconstruction technique for subchondral giant cell tumors around the knee

Cited by 5 publications

References 29 publications

Joint Salvage Using Sandwich Technique for Giant Cell Tumors around Knee

Joint Salvage Using Sandwich Technique for Giant Cell Tumors around Knee

Joint Salvage and Biological Repair of Massive-Cavity Bone Defects After Extensive Curettage of Campanacci Grade II or III Giant Cell Tumor Around the Knee With Vascularized Fibular Autograft and Cancellous Allograft

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

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