Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Tumours
Abstract number: 26683
RESECTION ARTHRODESIS FOR GIANT CELL TUMOURS AROUND THE
KNEE-TECHNIQUES AND RESULTS
Sunil Gurpur KINI, Aditya AGGARWAL, Sudhir KUMAR
University College of Medical Sciences, New-Delhi (INDIA)
Background: Segmental resection of bone in Giant cell tumor around the knee, in
indicated cases, leaves a gap which requires complex reconstructive procedure. This
study analyzes reconstructive procedures in terms of morbidity and complications
encountered. Materials and Methods: Thirteen cases (lower end femur-six and upper
end tibia -seven) of GCT around the knee,Campanacci Grade II or Grade III were
included. Mean age was 25.6 years Resection arthrodesis with telescoping over
intramedullary nail ( n=5), resection arthrodesis with intercalary allograft threaded
over long intramedullary nail ( n=3) and resection arthrodesis with intercalary fibular
autograft and simultaneous limb lengthening ( n=5) were procedures performed.
Results: Shortening was the major problem following resection arthrodesis with
telescoping over nail. Infection was the major problem in all cases of arthrodesis with
intercalary allograft threaded over long nail and required multiple drainage
procedures. In the third patient, allograft sequestrated. The patient underwent
sequestrectomy, telescoping of fragments and ilizarov fixator application with
subsequent limb lengthening. After resection arthrodesis with intercalary autograft
and simultaneous lengthening the resultant gap (~15cm) was bridged by intercalary
nonvascularized dual fibular strut graft and corticocancellous graft. Simultaneous
limb lengthening with distal tibial corticotomy was performed on ilizarov fixator. The
complications were superficial infection, stress fracture of fibula . Time taken for
union and limb length equalization was one year. Conclusion: Resection arthrodesis
with intercalary fibular autograft and cortico-cancellous bone grafting with
simultaneous limb lengthening achieved limb length equalization with relatively short
morbidity.
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