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J Knee Surg 2023; 36(12): 1218-1223
DOI: 10.1055/s-0042-1750749
Original Article

Total Knee Arthroplasty for Osteoarthritis Is Uncommon after Intralesional Curettage in Giant Cell Tumor of Bone

Linus Lee
1   Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, Illinois
,
Neil Buac
1   Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, Illinois
,
Matthew W. Colman
1   Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, Illinois
,
Steven Gitelis
1   Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, Illinois
,
Alan T. Blank
1   Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, Illinois
› Author Affiliations Funding None.
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Abstract

Giant cell tumor of bone (GCTB) is most often treated with intralesional curettage; however, periarticular lesions have been shown to increase risk for osteoarthritis. Additionally, the location of these lesions may occasionally preclude a joint-sparing procedure in recurrent tumors. This study sought to investigate rates of secondary arthroplasty in long-term follow-up of knee GCTB. Cases of knee GCTB treated at our institution were reviewed. Rates of recurrence and secondary arthroplasty were recorded, and Kaplan-Meier survival analyses were performed. The records of 40 patients were reviewed. Local recurrence occurred in 25% of patients. The 1-, 5-, and 10-year recurrence-free survival (RFS) probability was 87.4% (95% CI, 77.0–97.7), 72.4% (95% CI, 57.6–87.2), and 72.4% (95% CI, 57.6–87.2), respectively. Function improved after surgery with a mean preoperative MSTS score of 14.9 (standard deviation [SD] 8.4) and mean postoperative MSTS score of 25.1 (SD 5.6) (p <0.001). Three patients had evidence of radiographic osteoarthritis at the last follow-up though they did not require arthroplasty. Arthroplasty was performed as a secondary procedure in six patients. Five patients underwent arthroplasty for recurrent tumors after initial treatment with curettage and one patient underwent patellar arthroplasty for osteoarthritis after initial treatment with an allograft composite arthroplasty. Arthroplasty is performed as a secondary procedure in patients with GCTB at a relatively infrequent rate and more often for cases of recurrent disease than for osteoarthritis. Overall, patients treated for GCTB have improved functional outcomes after surgery than before. Large, multi-institutional studies may be required to assess the incidence of secondary osteoarthritis requiring arthroplasty as this was an infrequent finding in our cohort.

Keywords

giant cell tumor of bone - intralesional curettage - arthroplasty - polymethyl methacrylate

Authors' Contributions

L.L. contributed toward data collection, analysis, interpretation, drafting, editing, and revisions. N.B. did the data collection, interpretation, drafting, editing, and revisions. M.W.C. and S.G. contributed toward oversight, editing, and revisions. A.T.B. worked toward conception, oversight, editing, and revisions.


Ethical Approval

Rush University Medical Center obtained individual Institutional Review Board approval prior to beginning any research efforts.


Availability of Data

The data that support the findings of this study are available from the corresponding author upon reasonable request.




Publication History

Received: 16 February 2022

Accepted: 26 April 2022

Article published online:
28 July 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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