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Similar recurrence rates seen after curettage with local adjuvants for giant cell tumor of bone
Function and recurrence rates were similar between patients with giant cell tumors of bone treated with combinations of either phenol and polymethylmethacrylate, liquid nitrogen and polymethylmethacrylate or liquid nitrogen and bone grafts.
“Recurrence rates were comparable for treatment with phenol and polymethylmethacrylate and phenol, nitrogen and polymethylmethacrylate and liquid nitrogen and bone grafts,” the authors wrote in their study abstract. “Complication rates were higher after use of liquid nitrogen. The functional outcome was excellent in all three cohorts.”
The researchers retrospectively reviewed medical records of 132 patients who were treated at two centers for giant cell tumor of bone. The group had a mean age of 33 years and a mean follow-up of 8 years. Overall, 63 patients were women. Surgeons at one center treated patients with curettage with phenol and polymethylmethacrylate (PMMA), while patients at the second center were treated with curettage and either liquid nitrogen and PMMA or liquid nitrogen and bone grafts.
The researchers found no statistically significant differences in recurrence rates between the groups with a rate of 28% for the phenol and PMMA group, 31% for liquid nitrogen and PMMA group and 38% for liquid nitrogen and bone graft group. The researchers found soft tissue extension increased the recurrence risk and pathologic fractures or use of liquid nitrogen increased the complication risk. Complication rates were 33% for the liquid nitrogen and bone graft group, 27% for liquid nitrogen and PMMA group and 11% for phenol and PMMA group. The most common complications were osteoarthritis, infection, postoperative fracture, nonunion, transient nerve palsy and PMMA leakage.
Overall, the average Musculoskeletal Tumor Society score was 26 points in all groups.
“Treatment of giant cell tumor of bone remains challenging, as recurrence rates remain relatively high after curettage with local adjuvants,” the authors wrote in the study. “Functional outcome was excellent in all cohorts, making the relatively high recurrence rates acceptable.”
Disclosures: van der Heijden, van der Geest, Schreuder and van de Sande have no relevant financial disclosures. Dijkstra receives payments for lectures from Boerhaave Congress, Medtronic and Stryker.