Excision curettage and allografting of giant cell tumor.

Between 1987 and 1994 we followed 22 patients with giant cell tumors involving the long bones. Their average age was 31 years (range 17-50 years). Five patients had grade II tumors and the other 17 grade III lesions. The average volume of lesions after curettage was 231 ml (range 56-450 ml). All of the patients underwent a modified excisional curettage, and the cavity was filled with deep-frozen allogenic corticocancellous bone graft with supplementary fixation. Two patients developed postoperative complications including a superficial wound infection in one case and a traumatic tibial plateau fracture in one case. The overall outcome was good or excellent in 91% of the patients (i.e., 20/22 cases). There was no degenerative joint arthritis and, surprisingly, no instance of tumor recurrence. Allograft infection and fracture were not present. An allogeneic cortical strut with cancellous bone graft can be used safely and is effective for grafting cavitary lesions created after complete removal of the tumor.