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Clinical Orthopaedics and Related Research®

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01-10-2012 | Survey

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

Authors: Yu-peng Liu, MD, PhD, Kang-hua Li, MD, Bu-hua Sun, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 10/2012

Abstract

Background

Intralesional excision and en bloc resection are used to treat giant cell tumors (GCTs) of the distal radius. However, it is unclear whether one provides lower rates of recurrences and fewer complications, and whether the use of polymethylmethacrylate (PMMA) after curettage reduces the risk of recurrence.

Questions/Purposes

We examined whether curettage was associated with lower rates of recurrence and fewer major complications compared with en bloc excision, and whether PMMA resulted in lower rates of recurrence compared with a bone graft.

Methods

We systematically searched the literature using the criteria, “giant cell tumor” AND “curettage” OR “intralesional excision” OR “resection”. Six relevant articles were identified that reported data for 80 curettage cases (PMMA, n = 49; bone graft, n = 26; no PMMA or bone grafts, n = 5) and 59 involving en bloc excision. A meta-analysis was performed using these data.

Results

Overall, patients in the intralesional excision group had a higher recurrence rate (relative risk [RR], 2.80; 95% CI, 1.17–6.71), especially for Campanacci Grade 3 GCTs (RR, 4.90; 95% CI, 1.36–17.66), yet fewer major complications (RR, 0.21; 95% CI, 0.09–0.54) than the en bloc resection group. The use of PMMA versus bone graft did not affect the recurrence rate (RR, 0.98; 95% CI, 0.44–2.17).

Conclusions

Based on data obtained from the limited number of studies available, intralesional excision appears to be more appropriate for the treatment of local lesions (eg, Grades 1 and 2) than Grade 3 GCTs of the distal radius. Moreover, PMMA was not additionally effective as an adjuvant.

Level of Evidence

Level III, therapeutic study (systematic review). See Guidelines for Authors for a complete description of levels of evidence.

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Title: Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis
Authors: Yu-peng Liu, MD, PhD
Kang-hua Li, MD
Bu-hua Sun, MD, PhD
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 10/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2464-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

Abstract

Background

Questions/Purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/Purposes

Methods

Results

Conclusions

Level of Evidence

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