The effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases

Abstract

Chondroblastoma is a sporadic benign bone tumor originating from cartilage cells. Chondroblastoma was first accepted as an entity by Kolodny [1] in 1927 and was defined as a "giant cell variant". The term chondroblastoma was introduced by Jaffe and Lichtenstein [2] in 1942 and was included in the group of chondroid tumors by distinguishing it from giant cell tumors. It accounts for less than 1% of all bone tumors and 9% of benign bone tumors. [3] Chondroblastoma is mostly located in the epiphyses of long bones, with the most common localizations being the proximal humerus, distal femur, proximal femur, and proximal tibia. [4] It is very rare to be seen over the age of Objectives: This study aims to investigate the effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases.Patients and methods: Between January 2004 and December 2020, a total of 30 chondroblastoma cases (19 males, 11 females; median age: 18.6 years; range, 9 to 53 years) who were surgically treated were retrospectively analyzed. The pressurized-spray technique was performed using liquid nitrogen. Data including age, sex, radiological appearance, treatment modality, duration of follow-up, skin problems, and recurrence were recorded. All patients received adjuvant liquid nitrogen cryotherapy after extended intralesional curettage with high-speed burr. The bone cavity was filled with an autologous iliac crest bone graft, allograft, or polymethylmethacrylate (PMMA). Results:The median follow-up was 54 (range, 19 to 120) months. The lesion was located around the knee in 16 (53.3%), in the shoulder in seven (23.3%), around the hip in five (16.6%), and in the ankle in two (6.6%) cases. The defect was filled with an autologous iliac crest bone graft in 28 (93.3%), an additional allograft in eight (26.7%), and PMMA in two (6.7%) cases. Local recurrence was observed in only two (6.7%) patients during follow-up. Two (6.7%) patients developed physeal growth arrest. Osteoarthritic changes were observed in two (6.7%) patients (one knee and one hip) due to the periarticular location of the tumor. Three (10%) patients had skin complications. None of the cases had a pathological fracture. Conclusion:A well-performed extended intralesional curettage with high-speed burr is the first and essential step in treating chondroblastoma. Adding adjuvant liquid nitrogen cryotherapy with high-speed burr can improve treatment outcomes and significantly reduce the recurrence rate of this disease.

Chondromyxoid fibroma: A retrospective evaluation of 31 cases

“…[ 4 , 6 , 7 ] Chondroblastoma is frequently localized in the humerus; in contrast, CMF has been reported to be rarely seen in the humerus. [ 1 , 4 , 16 ] Similar to the literature, the most common three tumor locations in our cases were the pelvis, proximal tibia, and distal femur. Pain and swelling were the most frequently observed symptoms in our series, which is compatible with findings reported in other studies.…”