European Journal of Cardiovascular Medicine

Background: majority of the time, giant cell tumours (GCT) of the bone develop in the region of the long bones' metaphysis, frequently in contact with the articular cartilage. Their treatment remains controversial because of their high recurrence rate. Many studies have been conducted using various treatment techniques for GCT’s resection but less emphasis is given to managing it with curettage and cementation with internal fixation. Aim: Our study aims to evaluate the functional outcome of curettage and cementation with plate fixation in a giant cell tumor of a long bone.  Methods: This Interventional study was conducted between November 2020 to October 2021 in our orthopaedics department after clearance from the ethical committee. 27 GCT patients received treatment using extended curettage and cementation followed by plate fixation. All of these tumors were present around the knee: 21 at the distal femur and 6 at the proximal tibia. Preoperative radiological evaluation with standard X-rays showed that the tumour measured a mean 65 × 41 mm, for a mean volume of 70 cm3. Seventy-eight percent of these GCTs were in direct contact with the articular cartilage and 45% extended to the soft tissues as seen on the MRI. All patients were treated with extended curettage and cementation with plate fixation. Follow up was done after 1,3,8,12,24 weeks. All patients continue to be monitored, with none lost to follow-up. Functional evaluation was done using the Musculoskeletal Tumour Society (MSTS) scoring system for the lower extremity Results: The overall MSTS score was excellent in 22 patients (84%), good in 3 patients (11%), fair in 1 patients (0.03%), and poor in 1 patient (0.03%). The overall local recurrence rate was 0.07% (2 cases) and a 10% complication rate. There were no cases of fracture non-union or distant metastasis till 1 year follow up in all patients. Conclusion: GCTs around the knee with associated pathological fractures at diagnosis can be treated with curettage and cementation as cavity filling with cement has its own advantage of cytotoxic effect and mechanical support synergizing with the stability given by the plate to achieve an anatomic reduction and stable fixation. This procedure also has an added advantage of joint preservation in a younger age and varied mega-prosthetic procedures. This technique is a good and equivalent option along with other techniques using extending curettage.