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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 8/2013

01-08-2013 | Clinical Research

Iterative Curettage is Associated with Local Control in Giant Cell Tumors Involving the Distal Tibia

Authors: Saleh A. AlSulaimani, MBBS, Robert E. Turcotte, FRCSC, The Canadian Orthopaedic Oncology Society (CANOOS) collaborators

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2013

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Abstract

Background

The distal tibia is an unusual location for a giant cell tumor (GCT). Treatment choices are unclear because of their rarity, the anatomy of the ankle, and difficulties associated with reconstruction.

Questions/purposes

We assessed: (1) the treatment modalities used by participating Canadian bone tumor centers for distal tibia GCTs; (2) the incidence of local recurrence and their management; and (3) patients’ function after treatment.

Methods

A prospective tumor database served to identify all 31 patients with primarily treated distal tibia GCTs between 1991 and 2010. We extracted patients and tumor characteristics, treatment modalities for initial and recurrent tumors, and the Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage (TESS) scores. The median followup was 58 months (range, 24–192 months).

Results

Extended curettage was the only modality of treatment for all patients including all subsequent local recurrences. Nine had local recurrence, three of which had a second local recurrence; one had a third recurrence. Ultimately all patients were in remission at last followup. The local recurrence rate was 29% and appeared higher compared with recent series of all anatomic sites. The mean final MSTS and TESS scores were 91% (range, 71%–100%) and 88% (range, 35%–100%), respectively.

Conclusions

Extended curettage was the unique modality of surgical treatment for all tumors. We found the incidence of local recurrence higher than that reported for other locations but recurrences were manageable with repeated curettage. Complications and function appeared better than those reported for series of ankle fusion or reconstruction for bone tumors.

Level of Evidence

Level IV, retrospective study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Iterative Curettage is Associated with Local Control in Giant Cell Tumors Involving the Distal Tibia
Authors
Saleh A. AlSulaimani, MBBS
Robert E. Turcotte, FRCSC
The Canadian Orthopaedic Oncology Society (CANOOS) collaborators
Publication date
01-08-2013
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 8/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-013-2965-z

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