Tenosynovial giant cell tumor of the hip: a systematic review and institutional case series with Meta-analysis of recurrence and patient-reported outcomes

IF 3.6 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2026-06-01 Epub Date: 2026-05-25 DOI:10.1016/j.jbo.2026.100769

E. van der Loos , D.T. Meijer , J.A.M. Bramer , H.W.B. Schreuder , F.G.M. Verspoor

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引用次数: 0

Abstract

Background

Tenosynovial giant cell tumors (TGCT) are rare, locally aggressive neoplasms of the synovium, most frequently affecting the knee and less commonly the hip. Due to its deep anatomy and weight-bearing function, hip TGCT may follow a distinct clinical course. This study evaluates clinical presentation, treatment outcomes, recurrence patterns, and patient-reported outcomes in hip TGCT.

Methods

A systematic literature search in PubMed, Embase, and Cochrane Library (January 2000–May 2025) identified studies including ≥5 patients with hip TGCT reporting recurrence, complications, functional outcomes or patient-reported outcomes. A random-effects meta-analysis assessed recurrence risk across treatment modalities. Additionally, 23 patients of two retrospective institutional cohorts were analyzed, including PROMIS-CAT assessment.

Results

Seventeen studies comprising 269 patients were included. The mean age was 32 years and 58% were female. At diagnosis, 48% of patients with available cartilage data demonstrated advanced degeneration (grade ≥ 3). No statistically significant differences in recurrence risk were observed between treatment strategies; arthroscopic synovectomy, open synovectomy, and total hip arthroplasty. However, comparisons were limited by heterogeneous patient selection and follow-up duration. Arthroplasty was associated with the highest complication rate (33%), primarily aseptic loosening (19%). In the institutional cohort, 21.7% experienced recurrence and 29.4% required conversion to THA. Recurrences and conversions occurred exclusively in D-TGCT. PROMIS-CAT pain interference scores remained elevated (mean T-score 63.4 ± 11.1).

Conclusion

Hip TGCT shows substantial cartilage damage at diagnosis and persistent postoperative morbidity. While recurrence rates appear comparable between surgical strategies, arthroplasty carries a higher complication burden in this predominantly young population. Prospective multicenter studies with standardized outcome reporting are required to optimize treatment strategies.

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髋关节腱鞘巨细胞瘤：一项系统综述和机构病例系列，包括复发和患者报告结果的荟萃分析

背景：滑膜巨细胞瘤（TGCT）是一种罕见的滑膜局部侵袭性肿瘤，最常见于膝关节，较少见于髋关节。由于其深层解剖和负重功能，髋关节TGCT可能遵循不同的临床病程。本研究评估了髋关节TGCT的临床表现、治疗结果、复发模式和患者报告的结果。方法在PubMed、Embase和Cochrane图书馆（2000年1月- 2025年5月）进行系统文献检索，确定了包括≥5例髋关节TGCT患者报告复发、并发症、功能结局或患者报告结局的研究。一项随机效应荟萃分析评估了不同治疗方式的复发风险。此外，对两个回顾性机构队列的23例患者进行了分析，包括promise - cat评估。结果纳入17项研究，269例患者。平均年龄32岁，其中58%为女性。在诊断时，48%的可用软骨数据显示晚期退变（分级≥3级）。治疗策略间复发风险无统计学差异；关节镜下滑膜切除术，开放式滑膜切除术和全髋关节置换术。然而，比较受到异质性患者选择和随访时间的限制。关节置换术的并发症发生率最高（33%），主要是无菌性松动（19%）。在机构队列中，21.7%复发，29.4%需要转行THA。复发和转换仅发生在D-TGCT。promise - cat疼痛干扰评分仍然升高（平均t评分63.4±11.1）。结论髋关节TGCT诊断时显示软骨损伤明显，术后并发症持续存在。虽然两种手术策略的复发率相似，但在这主要是年轻人群中，关节置换术的并发症负担更高。需要有标准化结果报告的前瞻性多中心研究来优化治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.