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Journal ArticleDOI

Pathologic fracture of a giant cell tumour of the patella

01 Jan 2014-Vol. 14, Iss: 1, pp 6-10

TL;DR: This report describes a pathologic fracture of the patella secondary to destruction by a giant cell tumour, with osteolysis and soft tissue invasion.

AbstractThis report describes a pathologic fracture of the patella secondary to destruction by a giant cell tumour. Diagnosis was made after non-union of a patella fracture, with osteolysis and soft tissue invasion. Delayed union of any fracture should raise the possibility of an underlying pathologic process.

Topics: Patella fracture (68%), Pathologic fracture (59%), Patella (52%)

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Journal ArticleDOI
TL;DR: This dahlins bone tumors general aspects and data on 11 087 cases book will probably make you feel curious and help you to have willing to reach all benefits.
Abstract: When there are many people who don't need to expect something more than the benefits to take, we will suggest you to have willing to reach all benefits. Be sure and surely do to take this dahlins bone tumors general aspects and data on 11 087 cases that gives the best reasons to read. When you really need to get the reason why, this dahlins bone tumors general aspects and data on 11 087 cases book will probably make you feel curious.

505 citations


"Pathologic fracture of a giant cell..." refers background in this paper

  • ...The Mayo Clinic has presented a series of 671 GCTs of bone, only 1 of which was located in the patella([4])....

    [...]


Book
27 Jan 1982
TL;DR: Diagnosis in Orthopaedics Infection Rheumatic Disorders Crystal deposition Disorders Osteoarthritis and related disorders Osteonecrosis and osteochondritis Metabolic and endocrine disorders Genetic disorders Dysplasias and malfunctions Tumours Neuromuscular disorders Peripheral nerve injuries orthopaedic operations.
Abstract: Diagnosis in Orthopaedics Infection Rheumatic Disorders Crystal deposition disorders Osteoarthritis and related disorders Osteonecrosis and osteochondritis Metabolic and endocrine disorders Genetic disorders Dysplasias and malfunctions Tumours Neuromuscular disorders Peripheral nerve injuries Orthopaedic operations The shoulder The elbow The wrist The hand The neck The back The hip The knee The ankle and foot The management of acute injuries Principles of fractures Injuries of the upper limb Injuries of the spine Injuries of the pelvis Injuries of the lower limb Overuse injuries

349 citations


Journal ArticleDOI
TL;DR: The results of the present study suggest that the risk of local recurrence after curettage with a high-speed burr and reconstruction with autogenous graft with or without allograft bone is similar to that observed after use of cement and other adjuvant treatment.
Abstract: Background: The use of curettage, phenol, and cement is accepted by most experts as the best treatment for giant-cell tumor of bone. The present study was performed to evaluate whether equivalent results could be obtained with curettage with use of a high-speed burr and reconstruction of the resulting defect with autogenous bone graft with or without allograft bone. Methods: The prospectively collected records of patients who had a giant-cell tumor of a long bone were reviewed to determine the rate of local recurrence after treatment with curettage with use of a high-speed burr and reconstruction with autogenous bone graft with or without allograft bone. All of the patients were followed clinically and radiographically, and a biopsy was performed if there were any suspicious changes. Results: Fifty-nine patients met the criteria for inclusion in the study. According to the grading system of Campanacci et al., two patients (3 percent) had a grade-I tumor, twenty-nine (49 percent) had a grade-II tumor, and twenty-eight (47 percent) had a grade-III tumor. Seventeen patients (29 percent) had a pathological fracture at the time of presentation. The mean duration of follow-up was eighty months (range, twenty-eight to 132 months). Seven patients (12 percent) had a local recurrence. Six of these seven were disease-free at the latest follow-up examination after at least one additional treatment with curettage or soft-tissue resection (one patient). One patient had resection and reconstruction with a prosthesis after a massive local recurrence and pulmonary metastases. Conclusions: Despite the high rates of recurrence reported in the literature after treatment of giant-cell tumor with curettage and bone-grafting, the results of the present study suggest that the risk of local recurrence after curettage with a high-speed burr and reconstruction with autogenous graft with or without allograft bone is similar to that observed after use of cement and other adjuvant treatment. It is likely that the adequacy of the removal of the tumor rather than the use of adjuvant modalities is what determines the risk of recurrence.

291 citations


"Pathologic fracture of a giant cell..." refers background in this paper

  • ...High-speed burr extended curettage is associated with a 12% recurrence rate([6]); cryosurgery reduces the recurrence rate to 58%, however it is associated with pathologic fracture and vascular injury([7])....

    [...]


Journal ArticleDOI
TL;DR: Cryosurgery has the advantages of joint preservation, excellent functional outcome, and low recurrence rate when compared with other joint preservation procedures, and it is recommended as an adjuvant to curettage for most giant cell tumors of bone.
Abstract: Between 1983 and 1993, 102 patients with giant cell tumor of bone were treated at three institutions. Sixteen patients (15.9%) presented with already having had local recurrence. All patients were treated with thorough curettage of the tumor, burr drilling of the tumor inner walls, and cryotherapy by direct pour technique using liquid nitrogen. The average followup was 6.5 years (range, 4-15 years). The rate of local recurrence in the 86 patients treated primarily with cryosurgery was 2.3% (two patients), and the overall recurrence rate was 7.9% (eight patients). Six of these patients were cured by cryosurgery and two underwent resection. Overall, 100 of 102 patients were cured with cryosurgery. Complications associated with cryosurgery included six (5.9%) pathologic fractures, three (2.9%) cases of partial skin necrosis, and two (1.9%) significant degenerative changes. Overall function was good to excellent in 94 patients (92.2%), moderate in seven patients (6.9%), and poor in one patient (0.9%). Cryosurgery has the advantages of joint preservation, excellent functional outcome, and low recurrence rate when compared with other joint preservation procedures. For these reasons, it is recommended as an adjuvant to curettage for most giant cell tumors of bone.

268 citations


"Pathologic fracture of a giant cell..." refers background in this paper

  • ...High-speed burr extended curettage is associated with a 12% recurrence rate([6]); cryosurgery reduces the recurrence rate to 58%, however it is associated with pathologic fracture and vascular injury([7])....

    [...]


Journal ArticleDOI
01 Jan 2008-Bone
TL;DR: Clinical use of bisphosphonates as an adjuvant therapy for giant cell tumor of bone demonstrated a lower local recurrence rate and the clinical response seems to be more promising in stage III diseases.
Abstract: Background: Giant cell tumor (GCT) of bone is a benign but locally aggressive tumor that is characterized by the presence of mononuclear stromal cells and multinucleated giant cells. Although topical adjuvants have been used in the past, local recurrence following intralesional excision of GCT of bone continues to remain a problem. The use of bisphosphonates as an anti-osteoclastic agent in the management of osteolytic bone metastases is well accepted. Furthermore in vitro studies have shown that bisphosphonates also induce apoptosis in GCT stromal cells. Therefore our clinical study aims to investigate whether the administration of bisphosphonate as an adjuvant can further decrease local recurrence following the surgical treatment of GCT of bone. Method: A retrospective case–control study was performed between 1988 and 2004. Forty-four patients with histological diagnosed appendicular GCT were included. Intralesional curettage or wide excision of the lesions was followed with cementation or biological reconstruction. Additional intravenous and oral bisphosphonates were given peri-operatively to 24 patients who were treated between 1998 and 2004. The average follow-up of the control group was 115 months while that of the treatment group was 48 months. Results: In the bisphosphonate treated group, 1 of 24 patients (4.2%) developed local recurrence. In the control group, 6 of 20 patients (30%) developed local recurrence. The difference in the recurrence rate was statistically significant between the bisphosphonate treatment group and the control group (Log Rank test p = 0.056). The effect of reduction of local recurrence was significant in patients with stage III diseases. Patients treated with bisphosphonate did not report any untoward effects. Conclusion: Clinical use of bisphosphonates as an adjuvant therapy for giant cell tumor of bone demonstrated a lower local recurrence rate. The clinical response seems to be more promising in stage III diseases.

174 citations