Abstract
Aim
We investigated low grade intramedullary chondrosarcomas to see if curettage and cementation remains a strong alternative treatment to local resection.
Methods
39 patients with biopsy proven low grade chondrosarcoma treated with curettage and cementation in our clinic between 1993-2009. 32 were females and 7 were males. Mean age was 44. Mean follow up was 40.5 months. Anatomical localizations were 16 proximal humerus and 16 proximal femur, 6 distal femur and 1 proximal tibia. All patients had plain X-ray, CT scan, Tc99 bone scan and MRI before open biopsy. 28 patients had frozen intraoperative biopsy. Histological diagnosis were grade I chondrosarcoma in all our patients. Curettage followed by high speed burr and cementation with high viscosity bone cement was applied without any internal fixation. Active physiotherapy began after 2 days of the operation and full weight bearing is permitted at about 2 weeks later.
Results
At 72.6 months follow up 2 patients (1 proximal humerus, 1 distal femur) developed local recurrence at 3rd month and converted to local wide excision and reconstruction with tumour prosthesis. No infection occurred in the series. All patients followed by plain X-rays and if needed CT or MRI every third month in the first year and every fourth month at the second year and 6 months thereafter. Chest CT scans obtained at every 6 months for two years. No patient developed distant metastasis including recurrence cases.
Conclusion
Curettage and cementation in the treatment of low grade chondrosarcomas with a local recurrence rate of 5.1 percent proved itself as a safe and function sparing surgical method. Recurred patients turned out to be Grade II chondrosarcoma at the re-examination of resected specimens. Recurrences could be easily detected around bone cement and prompt resection with prosthetic replacement seemed to be effective
