Curettage with cement augmentation of large bone defects in giant cell tumors with pathological fractures in lower-extremity long bones.

Background: Thorough curettage and cement augmentation is the procedure of choice for treating giant cell tumor lesions, particularly those associated with large defects. Its association with pathological fractures has not been studied to a great extent, although a pathological fracture following a giant cell tumor is not a contraindication to treatment by curettage and cementation. We present our experience of bone cementation following intralesional curettage for treatment of giant cell tumors of the long bones of lower limbs with associated pathological fractures.
Materials and Methods: A total of 38 patients who had undergone a procedure in the weight-bearing long bones of lower limbs were included in the study. The age of the patients ranged from 18-79 years with a mean age of 38.57 years. The average follow-up was 102.42 months (8.5 years) ranging from 60-186 months (5-15.5 years). Results were based on serial radiographs showing consolidation of the lesion along with a subjective clinical examination and Enneking functional evaluation noted in the patient's records.
Results: Approximately 76 % of the lesions occurred around the knee. The results were graded as excellent (72 %), good (12.82 %) fair (10.25 %) and poor (5.12 %). Four cases developed a recurrence. Apart from a few documented complications, the lesions showed good consolidation and healed well.
Conclusion: Giant cell tumors of the long bones of lower limbs with an associated pathological fracture at diagnosis can be managed with thorough curettage and cement augmentation of the bone defect with a satisfactory outcome.
Level of Evidence: Level IV.
Competing Interests: The authors report no conflict of interest, financial or otherwise, concerning the material or methods used or the findings specified in this study. Funding There was no financial or material support for this study. Ethical standards 1. All patients gave informed consent prior to being included in the study. 2. All procedures involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments. 3. The study was approved by the Research Ethics Committee.