We retrospectively studied local recurrence of giant cell tumour in long bones following treatment with curettage and cementing in 137 patients. The median follow-up time was 60 months (3 to 166). A total of 19 patients (14%) had at least one local recurrence, the first was diagnosed at a median of 17 months (3 to 29) after treatment of the primary tumour. There were 13 patients with a total of 15 local recurrences who were successfully treated by further curettage and cementing. Two patients with a second local recurrence were consequently treated twice. At the last follow-up, at a median of 53 months (3 to 128) after the most recent operation, all patients were free from disease and had good function.

We concluded that local recurrence of giant cell tumour after curettage and cementing in long bones can generally be successfully treated with further curettage and cementing, with only a minor risk of increased morbidity. This suggests that more extensive surgery for the primary tumour in an attempt to obtain wide margins is not the method of choice, since it leaves the patient with higher morbidity with no significant gain with respect to cure of the disease.

Aims: A series of pelvic bone tumors with special reference to innovative operative procedures were examined. Methods: The series consisted of all patients treated surgically for pelvic bone tumors between 1981–2001. Results: There were 65 benign and 120 malignant tumors. Of the 65 benign tumors most were only biopsied or resected. Reconstructive methods were needed 16 cases, mostly they were cysts in the acetabular region that were þlled with cancellous bone.

48 of the malignant bone tumors were more than just biopsied. 32 were only resected, four hemipelvectomies were performed. 12 resections with reconstruction were done, þve times with endoprostheses, three times with PMMA, three times with bone grafting and once with osteosynthesis. The endoprosthetic solutions included two large pelvic reconstructions. Two large defects in the posterior pelvic ring were reconstructed with autogenous þbular grafts.

Pelvic rings left open after resection were susceptible to fatigue fractures, these cases were all treated conservatively. Large anterior reconstructions were reinforced with meshes to prevent herniation. Conclusion: In selected cases good function and stability is possible after large pelvic ring resections

Multiple hereditary exostoses is an autosomal dominant skeletal disorder in which there are numerous cartilage-capped excrescences in areas of actively growing bone. The condition is genetically heterogeneous, and at least three genes, ext1, ext2 and ext3 are involved. The reported risk for malignant transformation to chondrosarcoma has been from 0.6% to 2.8%. We have reviewed six generations of a family with 114 living adult members, 46 of them with multiple exostoses. Four have had operations for chondrosarcoma, giving the risk for malignant transformation as 8.3% in this family. Clinical and radiological examination revealed two additional patients with a suspicion of malignancy, but in whom the histological findings were benign. Reported elsewhere in detail, genetic linkage analysis mapped the causative gene to chromosome 11 and molecular studies revealed a guanine-to-thymine transversion in the ext2 gene. Patients with multiple hereditary exostoses carry a relatively high risk of malignant transformation. They should be informed of this possibility and regularly reviewed.