Abstract
Objective This is the first study to establish the utility of extended curettage with or without
bone allograft for Grade II giant cell tumors GCTs around the knee joint with the
aim of exploring postoperative functional outcomes.
Methods We retrospectively reviewed 25 cases of Campanacci grade II GCTs undergoing extended
curettage between January 2014 and December 2019. The participants were divided into
two groups: one group of 12 patients underwent extended curettage with bone allograft
and bone cement, while the other group of 13 patients underwent extended curettage
with bone cement only. Quality of life was assessed by the Revised Musculoskeletal
Tumor Society Score and by the Knee score of the Knee Society; recurrence and complications
were assessed for each cohort at the last follow-up. The Fisher test and two-sample
t-tests were used to compare the categorical and continuous outcomes, respectively.
Results The mean age was 28.09 (7.44) years old, with 10 (40%) males and 15 females (60%).
The distal femur and the proximal tibia were involved in 13 (52%) and in 12 (48%)
patients, respectively. There was no significant difference in the musculoskeletal
tumor society score (25.75 versus 27.41; p = 0.178), in the knee society score (78.67 versus 81.46; p = 0.33), recurrence (0 versus 0%; p = 1), and complications (25 versus 7.69%; p = 0.21).
Conclusions Extended curettage with or without bone allograft have similar functional outcomes
for the knee without any major difference in the incidence of recurrence and of complications
for Grade II GCTs. However, surgical convenience and cost-effectiveness might favor
the bone cement only, while long-term osteoarthritis prevention needs to be investigated
to favor bone allograft.
Keywords
giant cell tumors - bone grafting - bone cementing - extended curettage - knee/surgery
