Outcome Analysis Of Two Surgical Methods For 24 Cases Giant Cell Tumor Of Proximal Femur Bone

Objective:To evaluate the functional outcome and recurrence rate and complications of the proximal femur giant cell tumor treated with two surgical methods.Methods:Analysis 24 cases of the proximal femur giant cell tumor with complete follow-up date who were operated in Orthopedics department of Second Hospital of Shanxi Medical University.They were followed up from Jan.1998 to Nov.2008. They were 13 males and 11 females. The age was 16 to 83 years, with an average age of 32.6 years. The tumor sites were femoral neck (n=15), femoral neck and trochanteric (n=6), the femoral neck, trochanteric and subtrochanteric (n=3). There were Campanacci I (n=5),â…¡(n=10),â…¢(n=9).Among 24 patients,15 cases underwent the intracapsular curettage, namely:lesion curettage and bone grafting; 9 patients underwent extracapsular resection; namely:the tumor resection, special prosthetic replacement.Results:24 patients were followed up for 10 to 132 months, with an average of 50 months, the overall recurrence rate was 12.5%.15 cases underwent lesions curettage,bone grafting. After rested in bed for 3 mouths, then to walk with crutches without weight bearing.Average time of bone graft fusion was 6 months, after fusion, the hip joint function was well,daily life was not discomfort,3 cases recurred after surgery.They all came from Campanacci III patients. Recurrence rate was 20% (3/15), the recurrence occurred in 6th month, 17th month,30th month after surgery.9 cases were operated with tumor removal, special prosthetic replacement,2 to 3 weeks after surgery, they were exercised hip function with CPM,3 to 4 weeks after surgery, they left off bed to walk with crutches. The hip joint function lost in varying degrees without recurrence. Recurrence rate was 0. By bone and soft tissue tumors Society scoring system in 1993 (MSTS) combining Mankin comprehensive evaluation results,the score of lesion curettage and bone graft group was 28.6, the excellent rate was 80%(12/15); the score of tumor segmental resection, special prosthetic replacement group was 22.3, the excellent rate was 55.6%(5/9).Conclusions:For the proximal femur bone giant cell tumor, according to their age, the scope of invasion, stage, patients requirements for hip function, life expectancy, to use different surgical treatments, namely:lesion curettage and bone grafting; tumor segmental resection, special prosthetic replacement. Curettage and bone graft almost kept the normal anatomy of the proximal femur, when autologous grafted bone fusioned, the hip function had no significant difference comparing with the normal, it has a good joint function, but it was intracapsular excision, there was some recurrence rate; tumor resection, special prosthetic replacement could reach marginal even extensive excision, it has low recurrence rate, but the joint function lost in some degrees and had some complications. There was significant difference in limb function scores between curettage group and resection group (p<0.05).