Jose Kevin, Cherian Joe Joseph, Jeevo Jerin, Pilar Anoop, Krishnan Rinju, Nedumparambil Mevin Mathew
Department of Orthopaedics, St. John's Medical College Hospital, Bengaluru, Karnataka, India.
J Orthop Case Rep. 2025 Jun;15(6):197-202. doi: 10.13107/jocr.2025.v15.i06.5714.
Giant cell tumors (GCT) are benign yet locally aggressive neoplasms. The primary objectives of treatment are to entirely eliminate the tumor, rebuild the defect, and restore limb functionality. Numerous surgical treatment options have been proposed, ranging from more drastic interventions, such as en bloc excision, to less invasive techniques such as curettage or curettage combined with bone grafting. Limited research addresses the functional outcomes following treatment for giant cell tumors, despite the abundance of publications focusing on cure rates, recurrence, and other surgical considerations of the condition.
Individuals aged 20-40 are typically the ones affected with GCT. Patients typically exhibit pain during rest or sleep, and in certain instances, may also experience pathologic fractures.All patients were clinically evaluated, plain X-ray of the knee, chest X-ray, computed tomography , and magnetic resonance imaging were taken before the procedure. In all patients a pre-operative, biopsy was performed to determine the tumor's histological grade and to confirm the diagnosis.
The sandwich technique is an appropriate reconstructive procedure for GCT around the knee joint, involving the use of polymethylmethacrylate to occupy the residual cavity post-curettage, the placement of a structural allograft in the subchondral region, and the application of a gel form in the intervening space.It also has less complications, favorable survival rates, and positive functional outcomes. This approach preserves the advantages of cementing, mitigates potential complications, and restores the subchondral bone stock.None of our patients experienced any collapse of the joint, recurrences, immunological complications. All of them also had good functional status of the limb after 1 year. Thus, based on our good findings, we advocate this technique for joint salvage in GCTs around the knee.
骨巨细胞瘤（GCT）是良性但具有局部侵袭性的肿瘤。治疗的主要目标是完全消除肿瘤、修复缺损并恢复肢体功能。已经提出了许多手术治疗方案，从更激进的干预措施，如整块切除，到侵入性较小的技术，如刮除术或刮除术联合骨移植。尽管有大量关于该疾病治愈率、复发率和其他手术考虑因素的出版物，但针对骨巨细胞瘤治疗后功能结果的研究有限。
20 - 40岁的个体通常是受骨巨细胞瘤影响的人群。患者通常在休息或睡眠时出现疼痛，在某些情况下，还可能发生病理性骨折。所有患者在手术前均进行了临床评估，拍摄了膝关节平片、胸部X线、计算机断层扫描和磁共振成像。所有患者均进行了术前活检，以确定肿瘤的组织学分级并确诊。
三明治技术是膝关节周围骨巨细胞瘤的一种合适的重建手术，包括使用聚甲基丙烯酸甲酯填充刮除术后的残留腔隙，在软骨下区域放置结构性同种异体骨，并在中间间隙应用凝胶形式。它还具有较少的并发症、良好的生存率和积极的功能结果。这种方法保留了骨水泥固定的优点，减轻了潜在的并发症，并恢复了软骨下骨储备。我们的患者均未出现关节塌陷、复发、免疫并发症。1年后，他们所有人的肢体功能状态也都良好。因此，基于我们良好的研究结果，我们提倡这种技术用于膝关节周围骨巨细胞瘤的关节挽救。
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