EKSISI DAN MEGA PROSTHESIS PADA GIANT CELL TUMOR PROXIMAL TIBIA (LAPORAN KASUS)

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mujaddid Idulhaq ◽  
Bayu Sakti Jiwandono ◽  
Ariya Maulana Nasution ◽  
Handry TH
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Limb Salvage ◽  
Proximal Tibia ◽  
Skin Grafting ◽  
Cell Tumor ◽  
Limb Salvage Surgery ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Muscular Flap

Giant cell tumor (GCT) merupakan tumor destruktif tulang yang muncul di antara dekade kedua dan keempat, lokasi predileksi umumnya pada epifisis tulang panjang. Pemilihan tatalaksana operasi sangat penting dan masih menjadi perdebatan. Sebagaimana masih beragamnya pilihan tindakan pembedahan. Klasifikasi Campanacci dapat digunakan sebagai acuan untuk panduan tatalaksana. Pada kasus ini kami melaporkan seorang wanita, usia 18 tahun dengan diagnosa giant cell tumor pada proximal tibia dextra dengan Campanacci grade III. Pasien telah menjalani operasi limb salvage tahap pertama berupa eksisi luas pada proximal tibia dextra dan knee arthrodesis. Setelah 4 bulan dilakukan operasi limb salvage tahap kedua yaitu knee arthroplasty dengan megaprosthesis. Untuk mencegah komplikasi implant expose, dilakukan muscular flap dan split thickness skin grafting (STSG). Setelah dilakukan evaluasi selama 4 bulan, klinis pasien baik, pasien dapat berjalan alat bantu dan tanpa nyeri, tidak ada komplikasi pada luka operasi dan fiksasi implan baik. Kesimpulan yang didapatkan bahwa limb salvage surgery pada giant cell tumor proximal tibia dapat dilakukan dengan tindakan rekonstruksi dua tahap. Teknik muscular flap dan split thickness skin grafting (STSG) dapat digunakan untuk mencegah terjadinya implant expose.

scholarly journals GIANT CELL TUMOR OF THE RIGHT DISTAL FEMUR REGION IN A MALE 25 YEARS OLD WITH HIV POSITIVE (RARE CASE)

Biomedika ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 90-95
Author(s):  
Muhammad Riyadli ◽  
Mujaddid Idulhaq ◽  
Pamudji Utomo
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Limb Salvage ◽  
Distal Femur ◽  
Cell Tumor ◽  
Wide Excision ◽  
Hiv Positive ◽  
Limb Salvage Surgery ◽  
Knee Arthrodesis ◽  
The Right

Giant cell tumor (GCT) with Human Immunodeficiency Virus (HIV) infection is a rare case. At present, few literatures reported about GCT with HIV positive patients and there are no effective treatments of this disease currently. The aim of this article is to report the change the surgical treatment from limb salvage (wide excision and endoprostheses) to another way limb salvage (wide excision and knee arthrodesis) to minimize risk and further complication. A case of male, 25 years old, with diagnosis GCT of the right distal femur with HIV positive. In this case we administered antiretroviral treatment (ARV) and planned to limb salvage surgery (wide excision and knee arthrodesis).We follow up this patient in the first 4 weeks. There were no complaints, good postoperative wounds, no signs of infection, and histopathological examination postoperative showed the positive results of a GCT. The conclusion the surgical treatment from limb salvage (wide excision and endoprostheses) to another way limb salvage (wide excision and knee arthrodesis) could minimize risk and further complication.Keywords: Giant Cell Tumor, HIV,Limb Salvage Surgery, Wide Excision, Arthrodesis KneeGiant Cell Tumor (GCT) disertai dengan infeksi Human Imminodeficiency Virus (HIV) merupakan kasus yang jarang terjadi. Pada saat ini hanya sedikit literatur yang melaporkan kejadian pasien GCT dengan HIV positif dan belum ada standar terapi yang efektif. Tujuan dari artikel ini adalah melaporkan penggantian penatalaksanaan operatif sebelumnya berupa limb salvage (eksisi luas dan pemasangan endoprosthesis) menjadi eksisi luas dan arthrodesis knee untuk meminimalisir risiko dan kompikasi lebih lanjut. Kasus seorang laki-laki usia 25 tahun dengan diagnosis GCT pada distal femur kanan dengan infeksi HIV positif. Pada kasus ini, terapi yang diberikan adalah Anti Retroviral (ARV) dan operatif dengan limb salvage (eksisi luas dan arthrodesis lutut). Follow up pasien ini pada 4 minggu pertama post operasi. Keluhan nyeri berkurang, luka operasi baik, tidak ada tanda infeksi dan pemeriksaan histopatologi menunjukkan hasil GCT.Kesimpulannya bahwa penatalaksanaan operatif sebelumnya berupa limb salvage (eksisi luas dan pemasangan endoprosthesis) menjadi eksisi luas dan arthrodesis knee dapat meminimalisir risiko dan kompikasi lebih lanjut. Kata Kunci: Giant Cell Tumor, Hiv, Limb Salvage, Eksisiluas, Arthrodesis Lutut

scholarly journals Functional Outcomes of Limb Salvage Surgery in Patients with Giant Cell Tumor of Bone of the Lower Extremities: A Retrospective Study

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Daniela Kristina D. Carolino ◽  
Edwin Joseph R. Guerzon ◽  
Richard S. Rotor
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Limb Salvage ◽  
Functional Outcomes ◽  
Salvage Surgery ◽  
Lower Extremities ◽  
Cell Tumor ◽  
Limb Salvage Surgery ◽  
Msts Score

Giant cell tumor of the bone (GCTB) is a benign, locally aggressive neoplasm that is relatively rare, with a propensity to result in progressive bone destruction, and is associated with a high risk of recurrence. There is no widely held consensus regarding its ideal treatment. Worldwide, there are varying techniques ranging from intralesional curettage to resection of the lesion, supplemented with combinations of numerous adjuncts and fillers, depending on the resected amount and integrity of bone, as well as the preference of the surgeon. This was a cross-sectional study that included 20 patients who underwent limb salvage surgery for giant cell tumor of the bone of the lower extremities from January 2009 to February 2020 at two tertiary hospitals. The mean follow-up period was 37.3 months (SD=2.84). The extended curettage (EC) group had a mean Musculoskeletal Tumor Rating Scale (MSTS) score of 28.18 (SD=7.51) which is considered as an excellent outcome, while the resection (RS) group had an mean MSTS score of 19.67 (SD=11.02), which is considered as a good outcome. EC resulted to a total of eight complications (47%), while RS had one complication (33%). Prevalence of recurrence was noted to be 11.75% among those who underwent EC, while no recurrence was noted among those in the RS group. Use of bone cement as a filler was noted to have less recurrence as compared with the use of bone grafts, however were both were noted to result in excellent functional outcomes. Despite the prevalence of complications and recurrence of GCTB of the salvaged extremity in those who underwent EC, there is still report of excellent functionality. It is hence important to disclose all these possible outcomes and to stress the importance of compliance to follow-up for monitoring of these events.

scholarly journals Limb Salvage Surgery in Fungating Giant Cell Tumors: A Report of Three Cases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Namith Rangaswamy ◽  
Venkatesan Sampath Kumar ◽  
Roshan Banjara ◽  
Abdul Majeed ◽  
Devansh Goyal ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Cell Tumor ◽  
Limb Salvage Surgery ◽  
Salvage Procedure ◽  
Giant Cell Tumors ◽  
Distal Fibula ◽  
Mesh Reconstruction

Introduction: The WHO defines giant cell tumor as a benign locally aggressive neoplasm with metastasizing capacity and aggressive behavior. Very rarely, these tumors are seen fungating, mostly when neglected. But when they do, the treatment option commonly conferred is amputation of the limb which is disabling and traumatizing. Case Report: We report three cases of fungating limb masses (proximal tibia, distal fibula, and distal radius) diagnosed with giant cell tumor histologically, undergoing limb saving surgeries with various reconstruction techniques to endorse a good quality of life and functioning limb. Conclusion: Our study is one of the earliest to report medium-term follow-up after such limb salvage procedure. We recommend that salvage procedures should be considered in giant cell tumors even in the presence of fungation if there is no neurovascular encasement. Keywords: Giant cell tumor, fungation, limb salvage surgery, endoprosthesis, mesh reconstruction.

scholarly journals A case report: Reconstruction of a damaged knee following treatment of giant cell tumor of the proximal tibia with cryosurgery and cementation

2002 ◽  
Vol 10 (5) ◽  
pp. 402-407 ◽  
Author(s):  
S. Wakitani ◽  
K. Imoto ◽  
M. Saito ◽  
T. Yamamoto ◽  
H. Kawabata
Keyword(s):  
Case Report ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Proximal Tibia ◽  
Cell Tumor

Giant Cell Tumor of the Proximal Tibia

1989 ◽  
Vol 13 (2) ◽  
pp. 282-286 ◽  
Author(s):  
Jamshid Tehranzadeh ◽  
Brian J. Murphy ◽  
Walid Mnaymneh
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Proximal Tibia ◽  
Cell Tumor

scholarly journals Reconstruction and repair, using mini-plate and bone graft for persons living with HIV with giant cell tumor of long bone: retrospective analysis of a single-center experience

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Biao Xu ◽  
Rui Ma ◽  
Wen-sheng Zhang ◽  
Qiang Zhang ◽  
Chang-song Zhao ◽  
...  
Keyword(s):  
Bone Graft ◽  
Giant Cell Tumor ◽  
Retrospective Analysis ◽  
Giant Cell ◽  
Proximal Tibia ◽  
Cell Tumor ◽  
Long Bone ◽  
Hiv Positive ◽  
Joint Function ◽  
Mini Plate

Abstract Background To evaluate the effect of reconstruction and repair, using a mini-plate and bone graft for HIV -positive patients with giant cell tumor of long bone. Methods We conducted a retrospective analysis of 12 HIV positive patients with giant cell tumor of long bone. A non-HIV-positive cohort of patients, matched for age, sex, and disease type, was selected as the control group. From June 2012 to August 2020, curettage by ultrasonic scalpel was performed in all patients, combined with min- plate and bone graft treatment. All patients were followed- up for 18 to 60 months. Limb function was evaluated, using the MSTS93 scoring system, and any examples of postoperative recurrence, distant metastasis, complications, MSTS93 score, and fracture prognosis were recorded. Results The mean age of HIV group was 43.5 years. The ratio of men to women was 11: 1. In all cases the histopathological diagnosis was clear, except the patients with primary malignant giant cell tumor of bone, including five, three, two, and two cases in the proximal tibia, distal femur, distal tibia, and talus, respectively. Following their surgery, all patients were followed up with an average of 31.24 ± 11.84 months. No local recurrence or pulmonary metastases were observed. Post-surgery, all the 12 patients showed good bone morphologic repair and reconstruction, good bone healing, good joint function, and no pathological fractures around their lesion. In the HIV group, one case of giant cell tumor in the proximal tibia showed mild articular surface collapse and mild valgus deformity of the knee joint but retained good joint function. The MSTS scores of excellent or good in the two groups comprised 83.3%, thus, there was no significant difference between them (P > 0.05). Compared with preoperatively, the MSTS scores in the HIV group were significantly improved, ranging from 7 to 11 points preoperatively to 24 to 27 points postoperatively; this difference was statistically significant (P < 0.05). Conclusion Reconstruction and repair, using a mini-plate and bone graft for HIV -positive patients with giant cell tumor of long bone can achieve satisfactory results. The mini- plate requires little space and is flexible during reconstruction and fixation, significantly reducing complications such as surgical site infection, as well as preserving joint function and avoiding amputation; therefore, it is a safe and effective treatment method.

scholarly journals Management of an Unusual Periprosthetic Giant Cell Tumor of Bone of the Proximal Tibia

2018 ◽  
Vol 2 (9) ◽  
pp. e012
Author(s):  
Eric A. Chen ◽  
Dennis L. Caruana ◽  
Fazel A. Khan
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Proximal Tibia ◽  
Cell Tumor

scholarly journals Three-dimensional-printed porous implant combined with autograft reconstruction for giant cell tumor in proximal tibia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuqi Zhang ◽  
Minxun Lu ◽  
Li Min ◽  
Jie Wang ◽  
Yitian Wang ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Clinical Outcomes ◽  
Subchondral Bone ◽  
Proximal Tibia ◽  
Three Dimensional ◽  
Cell Tumor ◽  
Short Term ◽  
Porous Implant ◽  
The Mean

Abstract Background This study is to describe the design and surgical techniques of three- dimensional-printed porous implants for proximal giant cell tumors of bone and evaluate the short-term clinical outcomes. Methods From December 2016 to April 2020, 8 patients with giant cell tumor of bone in the proximal tibia underwent intralesional curettage of the tumor and reconstruction with bone grafting and three-dimensional-printed porous implant. Detailed anatomy data were measured, including the size of lesion and thickness of the subchondral bone. Prostheses were custom-made for each patient by our team. All patients were evaluated regularly and short-term clinical outcomes were recorded. Results The mean follow-up period was 26 months. According to the different defect sizes, the mean size of the plate and mean length of strut were 35 × 35 mm and 20 mm, respectively. The mean affected subchondral bone percentage was 31.5%. The average preoperative and postoperative thickness of the subchondral bone was 2.1 mm and 11.1 mm, respectively. There was no wound infection, skin necrosis, peroneal nerve injury, or other surgical related complications. No degeneration of the knee joint was found. Osseointegration was observed in all patients. The MSTS improved from an average of 12 preoperatively to 28 postoperatively. Conclusion The application of three-dimensional-printed printed porous prosthesis combined autograft could supply enough mechanical support and enhance bone ingrowth. The design and operation management lead to satisfactory subchondral bone reconstruction.

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