A study of 40 patients of chondroblastoma of extremities treated with curettage and reconstruction with bone graft or bone graft substitute or bone cement: What were the outcomes?

Abstract

Introduction: The purpose of this study was to evaluate the outcomes of surgical management of chondroblastoma in appendicular skeleton treated with curettage and reconstruction. Materials and Methods: This retrospective study included 40 patients of chondroblastoma treated with intralesional curettage and filling of defect with bone graft or bone graft substitute or bone cement. The patients were prospectively followed to consolidation of bone graft or bone graft substitute. The mean age of presentation was 14 years (13–32 years). There were 24 were male and 16 were female patients. The mean follow-up was 11 years (4–17 years). Results: The location of chondroblastoma was proximal tibia in 12 patients, distal femur in 14 patients, proximal femur in 8 patients, and proximal humerus in six patients. The physis was found open (8), closing (12), and closed (20) patients. The tumour was of Enneking grade of tumour was 1 in 22, II in 14 and III in 4 patients. The mean union time in bone graft group and bone graft substitute group 3 months and 4 months, respectively. There was local recurrence in six patients (3 in bone graft group and 2 in bone graft substitute group, 1 in bone cement group). The other complications were surgical site infection (two cases). The mean Musculoskeletal Tumor Society score in both groups was 27. Conclusion: Intralesional curettage provides excellent functional outcomes with preservation of adjacent joint mobility. The methods of reconstruction with bone graft, bone graft substitute, and bone cement provide optimal results, and the outcomes were comparable in all these groups.

Keywords

• bone cement
• bone graft substitute
• bone grafting
• chondroblastoma
• curettage