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The Role of Bone Grafting vs. Bone Cement in the Treatment of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis on the Risk of Recurrence in 1,454 Patients.

The Role of Bone Grafting vs. Bone Cement in the Treatment of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis on the Risk of Recurrence in 1,454 Patients.

Authors :
Costello JP 2nd
Travis LM
Jahn J
Pretell-Mazzini JA
Source :
JBJS reviews [JBJS Rev] 2024 Sep 05; Vol. 12 (9). Date of Electronic Publication: 2024 Sep 05 (Print Publication: 2024).
Publication Year :
2024

Abstract

Background: Giant cell tumor of bone (GCTB) presents a challenge in management due to its invasive nature and propensity for local recurrence. While either bone grafting (BG) or bone cement (BC) can be utilized to fill defects after intralesional curettage, the optimal treatment remains contested. The purpose of this study was to examine the impact of defect filling with BC compared with BG on recurrence rates in patients with GCTB following intralesional curettage.<br />Methods: A random-effects model binary outcome meta-analysis was performed utilizing recurrence rate for the BC and BG groups to evaluate the risk ratio (p < 0.05 considered significant). There were 1,454 patients included.<br />Results: Intralesional curettage with BG had a recurrence risk ratio of 1.68 (95% confidence interval [CI], 1.22-2.31, p = 0.001) when compared with BC. The overall rate of recurrence for GCTB after intralesional curettage with BC was 20.05% vs. 29.74% with BG (95% CI, 0.17-0.23 vs. 0.26-0.33, p < 0.001).<br />Conclusion: Intralesional curettage with BC for the treatment of GCTB demonstrated lower recurrence rates than intralesional curettage with BG. However, the rates of recurrence remain substantial for both groups, necessitating careful consideration of the benefits and potential pitfalls associated with BC vs. BG when considering salvage options after recurrences.<br />Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.<br />Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/B140).<br /> (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)

Details

Language :
English
ISSN :
2329-9185
Volume :
12
Issue :
9
Database :
MEDLINE
Journal :
JBJS reviews
Publication Type :
Academic Journal
Accession number :
39236154
Full Text :
https://doi.org/e24.00080