scholarly journals Clinical outcome of operative treatment in 18 cases of giant cell tumors of bones

2020 ◽  
Vol 10 (2) ◽  
pp. 67-71
Author(s):  
Suresh Pandey
Keyword(s):  
Clinical Outcome ◽  
Giant Cell ◽  
De Novo ◽  
Excellent Result ◽  
Giant Cell Tumors ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Non Union ◽  
Proximal Fibula

Background: Giant Cell Tumor of the bone (GCTB) has got variable outcome after the different methods of surgical treatment depending upon the site and grade of lesion and extent of tumor removal. This retrospective prospective analysis of operatively treated cases of GCTB of different sites aimed to highlight the clinical outcome. Methods: This was a prospective observational study of 18 cases of GCTB; proximal tibia (n=6), distal femur (n=5), distal radius (n=4), proximal femur (n=1), proximal fibula (n=1) and anterior arc of first rib (n=1) treated with different operative management with mean follow up of 53.61 months. Functional outcome with Musculoskeletal Tumor Society Score (MSTS), recurrence and complications were analyzed with at least 24 months of follow up. Results: There were 10 females and 8 males with average age at presentation 27.3 years (range 15-38). Average duration of symptom was 4.72 months. 2 were cases of recurrence previously op­erated and 16 were de novo cases. Mean MSTS was 84.27% with good to excellent result in 88%. There were no non-union, graft failure, metastasis, prosthetic failure or wound infection till at least 24 months of follow up in any of the cases. Conclusions: Extended curettage or reconstruction with auto graft in grade I and II tumor or en­doprosthesis in higher grade or recurrence of GCTB can give good to excellent functional result in majority of the cases.

scholarly journals Extensor Carpi Ulnaris Tenodesis Versus No Stabilization After Wide Resection of Distal Ulna Giant Cell Tumors

Hand ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 242-248 ◽  
Author(s):  
Ioannis D. Papanastassiou ◽  
Olga D. Savvidou ◽  
George D. Chloros ◽  
Panayiotis D. Megaloikonomos ◽  
Vasileios A. Kontogeorgakos ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Grip Strength ◽  
Giant Cell ◽  
Wide Resection ◽  
Giant Cell Tumors ◽  
Distal Ulna ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Extensor Carpi Ulnaris

Background: The necessity of stabilizing the residual ulnar stump after distal ulna tumor resection remains controversial. The authors retrospectively compared the outcome of patients who underwent wide resection of distal ulna giant cell tumors (GCTs) and reconstruction with tenodesis of the extensor carpi ulnaris (ECU) or without reconstruction. Methods: Between 2007 and 2015, 9 patients (6 females, 3 males; mean age, 36.8 years; range, 24-65 years) who underwent distal ulna resection for GCT of bone were retrospectively reviewed. The mean resection length was 8.1 cm. Five patients had no reconstruction, whereas 4 patients had stabilization of the ulnar stump using ECU tenodesis. With a mean follow-up of 3.6 years (2-9 years), the functional outcome using the quick Disability of Arm, Shoulder and Hand (DASH) score; Musculoskeletal Tumor Society score and grip strength; as well as the oncological outcome were evaluated. Results: Musculoskeletal Tumor Society functional scores were more than 24 in 7 patients and 20 to 24 in 2 patients (mean, 27.6 or 92%). Quick DASH scores ranged from 0 to 27.3 (mean, 11.1). In both groups, similar scores were observed ( P > .5). No patient had instability or pain related to the stump. There was no ulnar translation or subluxation of the radiocarpal joint. Grip strength in the operated hand, controlled for handedness, was 11% less than in the contralateral hand, although there was no difference between groups ( P > .4). All patients were disease-free at the latest follow-up. Conclusions: The distal ulna may be widely resected with or without stabilization of the residual ulnar stump, yielding satisfactory local disease control and functional outcome.

scholarly journals Outcome of modular megaprosthesis in management of Campanacci stage III giant cell tumor around the knee: a prospective study

2021 ◽  
Vol 8 (9) ◽  
pp. 2618
Author(s):  
Ritwika Nandi ◽  
Pinaki Das ◽  
Sujit Narayan Nandi
Keyword(s):  
Functional Outcome ◽  
Giant Cell ◽  
Giant Cell Tumors ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Tumor Excision ◽  
Bone Segment ◽  
The Mean ◽  
A Prospective Study ◽  
Large Bone

Background: Juxta articular giant cell tumors around the knee constitute 50-60% of the total cases reported. If the disease is detected at an advanced stage, reconstruction of the joint after tumor excision poses problems and has poor functional outcome. The aim of the study was to determine the functional outcome after resection of juxta-articular giant cell tumors around the knee and its reconstruction with mega prosthetic arthroplasty will be analyzed.Methods: Between January 2017 and March 2021, 14 patients in the age group of 28-48 years (mean=42.85 years) with Campanacci stage three giant cell tumors around the knee were studied (12-distal femur patients, 2-proximal tibia). Patients underwent tumor excision and reconstruction with modular megaprosthesis. They were evaluated post-operatively using the Revised Musculoskeletal Tumor Society Score (MSTS) for lower limb.  Results: All the patients were followed up for 12-44 months (mean=29.5 months), the average knee flexion at 6 months being 116.4 degrees. The mean MSTS at 6, 12, 18 and 24 months are 19.45, 23.23, 26.61 and 28.77 respectively. Complications observed were infection and tumor recurrence.  Conclusions: In advanced cases where tumor excision leaves large bone segment loss, reconstruction with megaprosthesis can give desirable functional outcome.

Outcome of modular megaprosthesis in management of Campanacci Stage III Giant cell tumor around the knee - A Prospective Study

2021 ◽  
Author(s):  
Ritwika Nandi ◽  
Pinaki Das ◽  
Sujit Narayan Nandi
Keyword(s):  
Functional Outcome ◽  
Giant Cell ◽  
Giant Cell Tumors ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Tumor Excision ◽  
Bone Segment ◽  
The Mean ◽  
A Prospective Study ◽  
Large Bone

Abstract Purpose : Juxta articular giant cell tumors around the knee constitute 50-60% of the total cases reported. If the disease is detected at an advanced stage, where it has already spread to extraosseous compartment or joint with pathological fractures, reconstruction of the joint after tumor excision poses problems and has poor functional outcome. In this article the functional outcome after resection of juxta-articular giant cell tumors around the knee and its reconstruction with mega prosthetic arthroplasty will be analyzed. Materials and methods: Between January 2017 and March 2021, 14 patients in the age group of 28- 48 years ( mean 42.85 years) with Campanacci Stage three giant cell tumors around the knee were studied . Distal femur was involved in 12 patients and proximal tibia in 2 patients. Patients underwent tumor excision and reconstruction with modular megaprosthesis. They were evaluated post-operatively using the Revised Musculoskeletal Tumor Society Score (MSTS) for lower limb. Results: All the patients were followed up for 12-44 months (mean 29.5 months), the average knee flexion at 6 months being 116.4 degrees. The Mean MSTS at 6 , 12 , 18 and 24 months are 19.45, 23.23, 26.61 and 28.77 respectively. Complications observed were infection and tumor recurrence. Conclusion: In advanced cases where tumor excision leaves large bone segment loss, reconstruction with megaprosthesis can give desirable functional outcome.

scholarly journals Custom-Made 3D-Printed Implants as Novel Approach to Reconstructive Surgery after Oncologic Resection in Pediatric Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 1056
Author(s):  
Giovanni Beltrami ◽  
Gabriele Ristori ◽  
Anna Maria Nucci ◽  
Alberto Galeotti ◽  
Angela Tamburini ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Soft Tissues ◽  
Lower Limbs ◽  
Host Bone ◽  
Limb Salvage Surgery ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Custom Made ◽  
3D Printed

Recently, custom-made 3D-printed prostheses have been introduced for limb salvage surgery in adult patients, but their use has not been described in pediatric patients. A series of 11 pediatric patients (mean age 10.8 years; range 2–13) with skeletal tumors treated with custom-made implants for the reconstruction of bony defects is described. Patients were followed up every 3 months. Functional results were evaluated by the Musculoskeletal Tumor Society Score (MSTS) for upper and lower limbs. The mean follow-up was 25.7 months (range 14–44). Three patients died after a mean of 19.3 months postoperatively—two because of disease progression and the other from a previous malignancy. Three patients experienced complications related to soft tissues. One patient required device removal, debridement, and antibiotic pearls for postoperative infection. Partial osseointegration between grafts and host bone was observed within a mean of 4 months. At the final follow-up, mean MSTS score was 75%. 3D prostheses may yield biological advantages due to possible integration with the host bone and also through the use of vascularized flaps. Further research is warranted.

Functional results of wrist arthrodesis versus arthroplasty with proximal fibula following giant cell tumour excision of the distal radius

2018 ◽  
Vol 44 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Huayi Qu ◽  
Wei Guo ◽  
Dasen Li ◽  
Yi Yang ◽  
Ran Wei ◽  
...  
Keyword(s):  
Grip Strength ◽  
Giant Cell ◽  
Distal Radius ◽  
Giant Cell Tumour ◽  
Functional Results ◽  
Cell Tumour ◽  
Musculoskeletal Tumor Society ◽  
Wrist Arthrodesis ◽  
Proximal Fibula ◽  
Radiocarpal Joint

Twenty-one patients underwent excision of a Campanacci grade III giant cell tumour of the distal radius and had reconstruction using a proximal fibula autograft. We compared the functional results of wrist arthrodesis versus arthroplasty. All 21 patients healed in an average of 8 months, and all have remained disease free. The Musculoskeletal Tumor Society 93, the Disabilities of the Arm, Shoulder, and Hand scores and the grip strength of the operated wrist compared with the contralateral wrist were 93%, 7, and 71% for the arthrodesis group and 83%, 17, and 40% for the arthroplasty group. Arthrodesis of the reconstructed radiocarpal joint provided better grip strength and functional outcomes than arthroplasty. Level of evidence: III

scholarly journals Pseudoarthrosis of second metatarsal fracture

2018 ◽  
Vol 40 (2) ◽  
Author(s):  
Jessica Zanovello ◽  
Barbara Bertani ◽  
Redento Mora ◽  
Gabriella Tuvo ◽  
Mario Mosconi ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Good Clinical Outcome ◽  
Non Union ◽  
Fractures In Children ◽  
Second Metatarsal ◽  
Traumatic Fracture ◽  
Metatarsal Fracture ◽  
Metatarsal Fractures ◽  
Foot Fractures

Metatarsal fractures make up the greatest portion of foot fractures in children. Most of them are treated with closed reduction and non-weightbearing cast immobilization.Usually, these fractures heal uneventfully and delay union and pseudoarthrosis are rare. We report a case of a 10-year-old child with non-union of the second metatarsal following a traumatic fracture, caused by an accident 10 months before, and treated successfully by osteosynthesis with plate and screws. Good clinical outcome was achieved at 2 years follow-up.

scholarly journals A Case Report of Giant Cell Tumor of Proximal Fibula in Children

2020 ◽  
Vol 4 (1) ◽  
pp. 64-67
Author(s):  
Sushil Adhikari ◽  
Arun Sigdel ◽  
Rajesh Kumar Sah ◽  
Luna Devkota
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Cell Tumor ◽  
Long Bone ◽  
Lytic Lesion ◽  
Radiographic Appearance ◽  
X Ray ◽  
Proximal Fibula ◽  
Aggressive Tumor

Giant cell tumour (GCT) is histopathologically benign tumor of long bone particularly in distal femur and the proximal tibia. It commonly occurs in adults of age 20-40 years but rare in children. GCT is considered to be locally aggressive tumor and tendency of recurrence is higher even after surgery. The clinical features are nonspecific, the principle symptoms are pain, swelling and limiting adjacent joint movements. Diagnosis is based on the radiographic appearance and histopathological findings .In our case X-ray showed ill defined lytic lesion on proximal fibula with cortical thinning and MRI finding revealed expansile lyticlesion in meta-epiphysis of right fibula 16×16×28mm adjacent to growth plate with fluid level. The sclerotic rim appears hypo intense on T1 & hyper intense on T2. Core needle biopsy showed giant cell tumor on proximal fibula. Considering the risk of recurrence wide local excision was done. Management of GCT of proximal fibula in young patient is critical for preventing recurrence and enhancing functional outcomes by saving adjacent anatomical structure. No evidence of local recurrence and metastasis was found in 24 months of follow up.

Reconstruction with Custom Unicondylar Hemiarthroplasty following Tumor Resection: A Case Series and Review of the Literature

2019 ◽  
Vol 33 (08) ◽  
pp. 818-824
Author(s):  
Joseph A. Ippolito ◽  
Megan L. Campbell ◽  
Brianna L. Siracuse ◽  
Joseph Benevenia
Keyword(s):  
Distal Femur ◽  
Weight Bearing ◽  
Tumor Resection ◽  
Case Series ◽  
Full Weight Bearing ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Optimal Function ◽  
Tumor Involvement

AbstractFor patients with tumors of the distal femur, options for limb salvage include tumor resection followed by reconstruction. While reconstruction commonly involves a distal femoral replacement, careful selection of patients with tumor involvement limited to a single condyle may be candidates for reconstruction with distal femur hemiarthroplasty. In these procedures, resection spares considerably more native anatomy. Three consecutive patients who underwent resection and reconstruction at the distal femur with custom unicondylar hemiarthroplasty are presented in this case series at a mean follow-up of 45 months (range, 26–78). In two cases, prostheses were utilized as a secondary procedure after failure of initial reconstruction. In one case, the custom prosthesis was utilized as the primary method of reconstruction. Mean Musculoskeletal Tumor Society disease-specific scores were 26.7 (range, 25–28). All patients achieved a return to full weight bearing, activities of daily living, and functional range of motion. In appropriately selected patients with tumors of the distal femur, reconstruction with custom unicondylar hemiarthroplasty provides benefits including optimal function postoperatively via preservation of tumor-free bone and ligamentous structures. Additionally, maintenance of greater bone stock may confer benefits to patients with pathology at a high likelihood for recurrence and need for subsequent procedures.

scholarly journals Long term term follow-up of tyrosine kinase inhibitors treatments in inoperable or relapsing diffuse type tenosynovial giant cell tumors (dTGCT)

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0233046 ◽  
Author(s):  
Mehdi Brahmi ◽  
Philippe Cassier ◽  
Armelle Dufresne ◽  
Sylvie Chabaud ◽  
Marie Karanian ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Giant Cell ◽  
Tyrosine Kinase Inhibitors ◽  
Kinase Inhibitors ◽  
Diffuse Type ◽  
Giant Cell Tumors

Disability burden in patients with tenosynovial giant cell tumors in the United States from employer perspective.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 92-92
Author(s):  
Feng Lin ◽  
Raluca Ionescu-Ittu ◽  
Irina Pivneva ◽  
Willy Wynant ◽  
Sherry Shi ◽  
...  
Keyword(s):  
Giant Cell ◽  
Linear Models ◽  
Joint Destruction ◽  
Unmet Need ◽  
The United States ◽  
Work Loss ◽  
Giant Cell Tumors ◽  
Limited Mobility ◽  
Comorbidity Burden

92 Background: Tenosynovial giant cell tumor (TGCT) is a rare locally aggressive tumor causing pain, swelling, joint destruction, and limited mobility. This study assessed the disability burden and the associated costs in TGCT patients from an employer’s perspective. Methods: A retrospective analysis was performed using medical and disability claims from the OptumHealth database. Incident patients 18-64 years old with a diagnosis of TGCT (as identified by ICD-9: 727.02, 719.2x; ICD-10: D48.1, D21.x, M12.2) were matched 1:10 to controls without TGCT based on age, gender, index year, and follow-up duration. Patients without earning and disability data were excluded. Days of work loss due to disability claims and absenteeism associated with medical visits were compared using Poisson regression models. Costs were compared using generalized linear models. Results: A total of 1,395 eligible TGCT patients were matched with 13,950 controls without TGCT. Despite similar demographics (36% female, mean age 45-47) and only slightly higher comorbidity burden (mean Charlson Comorbidity Index (CCI): 0.3 versus 0.2), TGCT patients had increased usage of analgesic drugs (44% versus 20%) and MRI tests (37% versus 3%), prior to their diagnosis, compared with controls. During follow-up, TGCT patients were more likely to have disability claims (15.1% vs. 5.6%; p < 0.001), had more disability claim days (9.5 versus 2.0; p < 0.001), medically related absenteeism days (9.9 versus 4.3; p < 0.001), and total days of work loss (19.4 versus 6.3; p < 0.001) per person-year compared with their matched controls. After adjusting for age, gender, index year and CCI score, the average annual indirect cost per person was greater for patients with TGCT than controls ($4,653 versus $1,902; p < 0.001). Conclusions: In addition to the known problems of pain, limitation of mobility, and eventual joint destruction, TGCT patients had substantial indirect costs associated with increased work absenteeism and disability. These findings highlight the unmet need for more effective treatments to reduce not only the medical, but also the economic burden of TGCT.

Sign in / Sign up

Export Citation Format

Share Document