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
