Abstract
Purpose: We report a retrospecitve series of 88 benign osteolytic tumours of the knee treated by curettage-filling between 1973 and 2000. The purpose of this analysis was to evaluate the role of curettage-filling in the treatment of this type of tumour.
Material and methods: Mean patient age was 31 years. The sex ratio was 1. Pain was the main sign and 9% of patients had a pathologic fracture. An equivalent number of tumours were found in the lower extremity of the femur and the upper extremity of the tibia. We analysed clinical features, imaging findings, treatments and complications, recurrence, and treatment of recurrence.
Results: Giant-cell tumours predominated (n=63), followed by aneurysmal cysts (n=7) and chondroblastomas (n=6). Tumours were treated by curettage associated with filling (n=83) and osteosynthesis (n=51). There were six cases of mechanical complications, but only two required total knee arthroplasty. No re-operations for arthrolysis were required. The recurrence rate after curettage was 23%; a second curettage-filling was performed after 90% of the recurrences.
Discussion: This study confirms that curettage-filling is the standard surgical treatment for benign osteolytic tumours of the knee, independently of histological type. This simple procedure with a low complication rate enables preservation of the joint in young subjects. We prefer this approach to resection-arthroplasty. We were unable to identify any factor predictive of local recurrence (histologic type of osteolytic tumour). Repeated curettage-filling is an appropriate treatment for recurrence.
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