A study of 40 patients of chondroblastoma of extremities treated with curettage and reconstruction with bone graft or bone graft substitute or bone cement: What were the outcomes?

A. Salunke, P. Amin, J. Pandit, Prem Haridas Menon, S. Pathak
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Abstract

Introduction: The purpose of this study was to evaluate the outcomes of surgical management of chondroblastoma in appendicular skeleton treated with curettage and reconstruction. Materials and Methods: This retrospective study included 40 patients of chondroblastoma treated with intralesional curettage and filling of defect with bone graft or bone graft substitute or bone cement. The patients were prospectively followed to consolidation of bone graft or bone graft substitute. The mean age of presentation was 14 years (13–32 years). There were 24 were male and 16 were female patients. The mean follow-up was 11 years (4–17 years). Results: The location of chondroblastoma was proximal tibia in 12 patients, distal femur in 14 patients, proximal femur in 8 patients, and proximal humerus in six patients. The physis was found open (8), closing (12), and closed (20) patients. The tumour was of Enneking grade of tumour was 1 in 22, II in 14 and III in 4 patients. The mean union time in bone graft group and bone graft substitute group 3 months and 4 months, respectively. There was local recurrence in six patients (3 in bone graft group and 2 in bone graft substitute group, 1 in bone cement group). The other complications were surgical site infection (two cases). The mean Musculoskeletal Tumor Society score in both groups was 27. Conclusion: Intralesional curettage provides excellent functional outcomes with preservation of adjacent joint mobility. The methods of reconstruction with bone graft, bone graft substitute, and bone cement provide optimal results, and the outcomes were comparable in all these groups.
一项对40例四肢软骨母细胞瘤患者进行刮除和骨移植物或骨移植物替代物或骨水泥重建治疗的研究:结果如何?
引言:本研究的目的是评估刮除和重建治疗阑尾骨骼软骨母细胞瘤的手术治疗效果。材料和方法:本回顾性研究包括40例软骨母细胞瘤患者,采用病灶内刮除和骨移植物或骨移植物替代物或骨水泥填充缺损。对患者进行了前瞻性的骨移植或骨移植替代物巩固随访。表现的平均年龄为14岁(13-32岁)。男24例,女16例。平均随访时间为11年(4-17年)。结果:软骨母细胞瘤的位置为胫骨近端12例,股骨远端14例,股骨近端8例,肱骨近端6例。发现有开放性(8例)、闭合性(12例)和闭合性(20例)的患者。肿瘤为Enneking级,22例中有1例,14例为II级,4例为III级。骨移植组和骨替代组的平均愈合时间分别为3个月和4个月。6例患者局部复发(骨移植组3例,骨移植替代组2例,骨水泥组1例)。其他并发症为手术部位感染(2例)。两组的平均肌肉骨骼肿瘤学会评分均为27。结论:病灶内刮除术在保留相邻关节活动性的情况下提供了良好的功能结果。用骨移植、骨移植替代物和骨水泥重建的方法提供了最佳的结果,并且所有这些组的结果都是可比较的。
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