Introduction and Aims: The treatment of Giant Cell Tumor (GCT) of bone ranges from resection to intra-lesional excision. The latter procedure preserves the joint and function. The purpose of this paper is to review functional and oncological outcomes for GCT treated by intralesional excision.

Method: The medical records including radiology and pathology of 40 consecutive patients with GCT were retrospectively reviewed. Demographics, complications, tumor local control were determined. Functional evaluation using the MSTS system was performed on 23 patients. The data was subject to statistical analysis.

Results: Forty patients (19M/21F). Mean age 28 years. Sites: femur 17, tibia 14, radius five, other four. Mean follow-up 90.3 months (26–178). Functional outcome: 93.2% (50–100). Complications: DJD two, fracture one. Recurrence: five (12.5%). Recurrence sites: Tibia two, femur one, radius one, and talus one. Recurrence treatment: 1/5 resection, 4/5 repeat intralesional excision. Recurrence outcome: 5/5 NED (mean 58.2 months).

Conclusion: GCT treated by intralesional excision had excellent functional and oncological outcomes. The joint was preserved in most patients (95%) except due to recurrence 1 and fracture 1. The recurrences were successfully treated by repeat excision in 4/5 patients. Intralesional excision should be considered the preferred treatment for most giant cell tumors.

Text: Chronic osteomyelitis is a serious condition. The infection can be difficult to eradicate and destroy significant bone. Usual therapy includes debridement, systemic antibiotics and local antibiotic delivery with polymethylmethacrylate (PMMA). PMMA needs to be removed and does not aid in bone repair.

Purpose: To review the use of calcium sulfate (OSTE-OSET® loaded with Vancomycin 3.2% or Tobramycin 3.8%) as an antibiotic delivery and bone repair implant.

Methods: Six consecutive patients were reviewed. Clinical records, radiographs, bone repair, sedimentation rate, functional outcome (Enneking MSTS system) were evaluated. All patients were treated with a surgical debridement, degradable implants and six weeks of systemic antibiotics.

Results: Six patients (3M/3F), mean age 50 years. Site; tibia 3, femur 3. Organism: Staph Aureus 5, mixed 1. Defect size; 40 cubic centimeters (12–60). Pre op sed rate; 54 (22–105). Local antibiotic; tobramycin 5, tobra+vancomycin 1. Follow-up; 22 months (12–31). Follow up sed rate; 8, Follow-up defect size; 2.5 cubic centimeters. Bone repair, 91%. Follow-up functional score; 27.5/30. No fractures, infection relapses or additional surgery to date.

Discussion: Local antibiotic delivery with calcium sulfate (OSTEOSET®) proved to be effective for bone repair. This implant does not need to be removed and may be an adjunct to systemic antibiotics for chronic osteomyelitis.