Abstract
This is a retrospective study of 14 cases from clinical records and the Bone Tumour Registry over the last 20 years. The mean follow-up time was 27 months (3 to 60). Two of the cases were referred elsewhere for final treatment and the relevant clinical records were obtained by correspondence with the treating doctor. Most tumours occurred about the knee, with two in the distal femur and five involving the proximal tibial metaphysis. Three were in the forearm and one in the humerus.
Once diagnosis had been made on clinical and radiological grounds, the tumours were curetted. Cryosurgery was used in four cases and phenol in two. Structural integrity was restored by autogenous bone grafting in most cases. Two of these were vascularised free grafts. Two patients had arthrodeses (one ischiofemoral and one wrist) and two were referred for custom-made joint replacements. There was only one local recurrence. Of the adverse outcomes, three required late amputations, one for varus malunion and recurrence, and two for nonunion and chronic sepsis.
Giant cell tumour of bone has a low rate of recurrence. The treatment challenge is to avoid sepsis and graft collapse. Large bone grafts often fail to incorporate fully, which can lead to angular deformities. A combination of bone cement, reinforced with Ender rods with bone cement to the subchondral surface, promises to be a more satisfactory method in and around the knee.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
