Ebeid Walid A, Hasan Bahaa Z, Badr Ismail T, Mesregah Mohamed K
Orthopedic Surgery Department, Faculty of Medicine, Cairo University.
Orthopedic Surgery Department, Faculty of Medicine, Menoufia University, Egypt.
J Pediatr Orthop. 2019 Apr;39(4):e312-e317. doi: 10.1097/BPO.0000000000001293.
Chondroblastoma is a rare cartilaginous benign bone tumor that commonly arises in long bones of young people. Surgical management is the primary treatment of choice for chondroblastoma and it entails adequate intralesional curettage alone or in combination with adjuvants. This study was performed to describe the epidemiological characteristics and clinical and radiologic results of intralesional curettage of chondroblastoma.
This was a retrospective study which included an analysis of 91 patients with chondroblastoma who were treated with intralesional curettage and were followed up between 1994 and 2014 for at least 3 years. Epidemiological data, clinical symptoms, radiologic and histologic investigations, surgery, functional outcomes, complications, and local recurrence rate were analyzed.
There were 60 males (65.9%) and 31 females (34.1%) with a mean age of 16.4 years. The most commonly involved bone was the proximal tibia in 24 patients (26.4%), followed by distal femur in 20 patients (22%), proximal humerus in 17 patients (18.7%) and proximal femur in 15 patients (16.6%). All patients underwent intralesional curettage. High-speed burr was used in 66 patients (72.5%). The resultant cavity was filled with autogenous bone graft, bone substitute, bone cement or a combination of bone graft and cement. Four patients (4.4%) had complications. Three patients (3.3%) developed local recurrence. Age, site, history of previous intervention or pathologic fracture had no impact on the rate of recurrence. The mean Musculoskeletal Tumor Society (MSTS) score was 28.88 (range, 24 to 30) points.
Thorough curettage using high-speed burr and bone-grafting or bone cement in the treatment of chondroblastoma has good local control, low recurrence rate and excellent functional long-term outcome.
Level IV, retrospective case series.
软骨母细胞瘤是一种罕见的软骨性良性骨肿瘤，常见于年轻人的长骨。手术治疗是软骨母细胞瘤的主要治疗选择，包括单纯充分的病灶内刮除或联合辅助治疗。本研究旨在描述软骨母细胞瘤病灶内刮除的流行病学特征以及临床和放射学结果。
这是一项回顾性研究，分析了91例接受病灶内刮除治疗的软骨母细胞瘤患者，这些患者在1994年至2014年期间接受随访，随访时间至少为3年。分析了流行病学数据、临床症状、放射学和组织学检查、手术情况、功能结果、并发症及局部复发率。
60例男性（65.9%），31例女性（34.1%），平均年龄16.4岁。最常受累的骨为24例（26.4%）近端胫骨，其次是20例（22%）远端股骨、17例（18.7%）近端肱骨和15例（16.6%）近端股骨。所有患者均接受病灶内刮除。66例（72.5%）使用高速磨钻。刮除后的空腔用自体骨移植、骨替代物、骨水泥或骨移植与骨水泥的组合填充。4例（4.4%）出现并发症。3例（3.3%）发生局部复发。年龄、部位、既往干预史或病理性骨折对复发率无影响。肌肉骨骼肿瘤学会（MSTS）平均评分为28.88分（范围24至30分）。
在软骨母细胞瘤治疗中，使用高速磨钻彻底刮除并植骨或使用骨水泥，具有良好的局部控制效果、低复发率和出色长期功能结果。
IV级，回顾性病例系列。
