Department of Orthopaedics, The General Hospital of Jinan Military Commanding Region, Jinan, Shandong 250031, China.
Department of Bone Oncology, Tianjin Hospital, Tianjin 300211, China.
Chin Med J (Engl). 2017 Nov 5;130(21):2541-2546. doi: 10.4103/0366-6999.217093.
Intralesional excision with curettage is the standard method of giant cell tumor (GCT) treatment, but the ideal filling material after curettage remains controversial. The purpose of this study was to compare the oncological and functional outcomes which underwent cementation or bone grafting after GCT curettage around the knee.
We reported 136 cases with GCTs in distal femur or proximal tibia who accepted curettage from five clinical centers during the last 15 years. All patients were divided into two groups according to filling materials. Recurrence-free survival proportions were used to evaluate oncological outcomes while the Musculoskeletal Tumor Society (MSTS) 93 functional score was used to evaluate functional outcomes. Other parameters including surgical complication, general condition, and radiological classification had been analyzed. The valid statisitical data was analyzed using SPSS 13.0 software.
After GCT curettage, 86 patients (63.2%) accepted bone grafting while 50 patients (36.8%) accepted cementation. There was no statistical difference in age, gender, tumor location, radiological classification, fixation, follow-up time, and MSTS 93 functional score between cementation group and bone grafting group. The recurrence-free survival proportions showed that the recurrence rate in bone grafting group was higher than it in cementation group (P = 0.034). Surgical complication was lower in cementation group than that in bone grafting group but without statistically significant difference (P = 0.141).
Parameters including patients' age, gender, tumor location, and radiological classification did not affect surgeons' treatments in cavity filling after GCT curettage. Cementation should be recommended because of easy usage, the similar postoperative knee function with bone grafting, and the better local tumor control than bone grafting.
病灶内切除术联合刮除术是治疗骨巨细胞瘤（GCT）的标准方法，但刮除术后理想的填充材料仍存在争议。本研究的目的是比较膝关节周围 GCT 刮除术后行骨水泥填充或植骨的肿瘤学和功能结果。
我们报告了来自五个临床中心的过去 15 年中接受 GCT 刮除术治疗的 136 例股骨远端或胫骨近端 GCT 患者。所有患者均根据填充材料分为两组。无复发生存率用于评估肿瘤学结果，而肌肉骨骼肿瘤学会（MSTS）93 功能评分用于评估功能结果。还分析了其他参数，包括手术并发症、一般情况和影像学分类。使用 SPSS 13.0 软件对有效统计数据进行分析。
GCT 刮除术后，86 例（63.2%）患者接受植骨，50 例（36.8%）患者接受骨水泥填充。骨水泥组和植骨组在年龄、性别、肿瘤部位、影像学分类、固定方式、随访时间和 MSTS 93 功能评分方面无统计学差异。无复发生存率表明植骨组的复发率高于骨水泥组（P = 0.034）。骨水泥组的手术并发症发生率低于植骨组，但无统计学差异（P = 0.141）。
患者年龄、性别、肿瘤部位和影像学分类等参数不影响 GCT 刮除术后空腔填充的治疗方法。骨水泥填充具有使用方便、术后膝关节功能与植骨相似、局部肿瘤控制优于植骨等优点，应推荐使用。
