CEMENT VERSUS FRAGMENTED ALLOGRAFT FOR FILLING GIANT-CELL TUMOR DEFECTS OF THE KNEE JOINT

Abstract

Purpose of the study: The purpose of this study was to compare two reconstruction procedures in terms of efficacy for tumor eradiation, reconstruction complications, and potential joint consequences.

Material and methods: This retrospective study included 43 patients with a giant-cell tumor located in the knee. Patients were treated by curettage combined with phenolization. Mean follow-up was seven years. Bone defects were filled with cement in 22 patients and with a fragmented allograft in 21. The reconstruction and potential joint degradation were assessed on standard x-rays obtained in the two groups.

Results: There were four cases of local recurrence (9%), two in each group. Three patients in the cement group required revision because of joint degradation in two and cement intrusion into the joint in the third. In the allograft group, two patients developed complications (fracture and massive resorption). Plan x-rays revealed joint deterioration in 10/17 patients with an allograft. The difference was significant (p=0.019).

Conclusion: The rate of local recurrence and complications after reconstruction requiring a revision procedure was not significantly different in the two groups. There was however a significantly greater radiographic degradation in patients with a bone defect filled with cement compared with those with a defect filled with a fragmented allograft.