Extended curettage and reconstruction with bonegrafting or combined bone graft and cement(Sandwich Technique) in giant cell tumors (GCT) ofbone – Prospective study of Functional Outcome

Treatment of giantcell tumors (GCTs) of bone is generally either curettage with bonegrafting or combined bone grafting and cementing (sandwich technique) or wide en bloc resection of the lesion. This study aims to find out the early functional outcomes after extended curettage and reconstruction using either bone graft sandwich technique with or without internal fixation.

Seventeen patients who had giantcell tumor of bone and were managed with extended curettage and reconstruction using either bone grafting or sandwich technique between July 2007 and April 2009 were studied. Aggressive curettage was done with the use of various adjuvants like high speed burr, hydrogen peroxide, and phenol and alcohol application in suitable cases.

After a median duration of followup of 14.5 months, the average MSTS score at final follow up was 24.59. Age, gender, grade of tumor, technique and recurrence had no significant effect on the eventual functional outcome achieved by the patients. There was 1 patient with GCT of the lower end of radius who had a unicortical fracture postoperatively which was managed conservatively in cast. There was one recurrence in these 17 patients (6%); however a longer follow up will be required to comment on the recurrence rate.

We concluded a good to excellent functional outcome without compromise of prognosis, can be achieved by using a bone graft or sandwich technique following extended curettage. Most patients could resume their previous work and reach the earlier level of physical activities. Age, gender, grade of tumor, technique had no significant effect on the eventual functional outcome achieved by the patients. A longer duration of followup of a larger group of patients is necessary to study the recurrence rates.