Surgical treatment and prognosis analysis of giant cell tumor of patellar
Objective The clinical manifestations,imaging manifestations and surgical treatment of giant cell tumor of patella were retrospectively analyzed in order to explore the reasonable surgical methods and the influence on the results of postoperative oncological outcome and the function of the affected limb.Methods A retrospective study was conducted on 15 patients with patellar giant cell tumors who underwent surgical treatment in Beijing Jishuitan Hospital from January 2008 to December 2021,including 8 males and 7 females,with an average age of 25.9(13-50)years.The extent,boundary,degree of bone damage to the tumor,and the surrounding normal bone mass was evaluated based on imaging examinations pre-operative.The surgical plan was developed with patellar preserved tumor curettage or patellar removed tumor resection.The bone grafting or bone cement is used to fill the bone defect after tumor curettage.Reconstruction of knee extension device was performed with artificial ligament after patellar resection.Results The surgical methods included en-block resection in 6 cases and tumor curettage in 9 cases.The average postoperative follow-up time was 38.7(median 31,12-117)months.Two cases(13.3％)experienced postoperative recurrence and both of which were after tumor curettage.The Kaplan-Meier method analysis showed a 5-year recurrence free survival rate of 91.9％.The postoperative recurrence rate of the intracapsular boundary was 22.2％(2/9)and the postoperative recurrence rate of the margin and wide boundary was 0(0/6),with no statistically significant difference between two groups(P＞0.05).When visiting our hospital,the postoperative recurrence rate of recurrent cases and primary cases were 33.3％(1/3)and 8.3％(1/12)respectively,with no statistically significant difference between two groups(P＞0.05).The recurrence rates of Campanacci stage 2 and stage 3 cases were 16.7％(1/6)and 11.1％(1/9)respectively,with no statistically significant difference between two groups(P＞0.05).Conclusion The tumor curettage surgery can preserve the structure and function of the patella,but there is a certain risk of postoperative recurrence.For cases with extensive or recurrent tumor involvement,it is recommended to undergo resection surgery.Artificial ligaments and muscle flaps can be used to reconstruct the knee extension device,allowing patients to achieve acceptable postoperative function.
Giant cell tumor of bonePatellaSurgical treatmentRecurrence
NETL
NSTL
万方数据
