Does the use of polymethyl-methacrylate cement after intralesional curettage of giant cell tumors of appendicular bone guarantee reduced local recurrence rates? A retrospective analysis.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Surgery Pub Date : 2023-09-01 DOI:10.1177/10225536231202155
Thomas Colding-Rasmussen, Peter F Horstmann, Peter H Jørgensen, Werner Hettwer, Bjarne H Hansen, Christian Nai En Tierp-Wong, Michael M Petersen
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Abstract

Purpose: Polymethyl-methacrylate cement (PMMA) is often used as bone defect reconstruction material after surgical removal of giant cell tumors. The purpose of this study was to investigate if the application of PMMA improves the local recurrence rates for giant cell tumors (GCT) of appendicular bone treated with intralesional curettage.

Methods: A retrospective analysis of all appendicular GTCs treated at two major Danish sarcoma centres between the 1st of January 1998 and December 31st 2013; minimum follow-up of 3.0 years (median: 8.9; 1.3-18.7 years). Kaplan-Meier survival model, log-rank and multivariate Cox regression were used to calculate and compare local recurrence rates. p-values <0.05 were considered statistically significant.

Results: 102 patients (M59/F43), median age 31Y (11-84) were included in this study. The overall 3-years local recurrence-rate was 19.9% (95%CI: 11.9-27.9%); 91% had occurred within 3 years. In patients treated with intralesional curettage (n = 64), the 3-years recurrence-rate was 30.6% (95%CI: 18.8-42.4%), compared to 2.6% (95%CI: 0.0-7.8%) in patients treated with wide resection or amputation (n = 38), p < .001. The 3-years recurrence-rate for patients treated with intralesional curettage and reconstruction using PMMA was 29.0% (95%CI: 12.6-45.4%) and without PMMA: 31.8% (95%CI: 15.2-48.4%), p = .83.

Conclusion: We found that the use of PMMA for bone defect reconstruction after intralesional curettage of GTCs in the appendicular skeleton did not ensure a reduced risk of local recurrence.

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阑尾巨细胞瘤病灶内刮除术后使用聚甲基丙烯酸甲酯骨水泥能保证降低局部复发率吗?回顾性分析。
目的:聚甲基丙烯酸甲酯骨水泥(PMMA)是巨细胞瘤手术后常用的骨缺损重建材料。本研究的目的是研究PMMA的应用是否能提高病灶内刮除治疗的阑尾骨巨细胞瘤(GCT)的局部复发率。方法:对1998年1月1日至2013年12月31日在丹麦两个主要肉瘤中心接受治疗的所有阑尾GTCs进行回顾性分析;最小随访3.0年(中位数:8.9;1.3-18.7年)。Kaplan-Meier生存模型、log秩和多变量Cox回归用于计算和比较局部复发率。p值结果:本研究包括102名患者(M59/F43),中位年龄31Y(11-84)。总的3年局部复发率为19.9%(95%可信区间:11.9-27.9%);91%发生在3年内。在接受病灶内刮除治疗的患者(n=64)中,3年复发率为30.6%(95%CI:18.8-42.4%),而接受广泛切除或截肢治疗的患者的3年复发性为2.6%(95%CI:00-7.8%)(n=38),p<0.001。使用PMMA进行病灶内刮除和重建的患者的3年复发率为29.0%(95%CI:12.6-45.4%),不使用PMMA:31.8%(95%CI:15.2-48.4%),p=.83。
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来源期刊
Journal of Orthopaedic Surgery
Journal of Orthopaedic Surgery ORTHOPEDICS-SURGERY
CiteScore
3.10
自引率
0.00%
发文量
91
审稿时长
13 weeks
期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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Does the use of polymethyl-methacrylate cement after intralesional curettage of giant cell tumors of appendicular bone guarantee reduced local recurrence rates? A retrospective analysis. Letter to the editor regarding "the analgesic effect and safety of duloxetine in total knee arthroplasty: A systematic review". Orthopaedic surgery academic productivity - how do we measure up? Therapeutic effect of C-type natriuretic peptide on persistent pain in a rat knee arthritis model. Expression and diagnostic significance of integrin beta-2 in synovial fluid of patients with osteoarthritis.
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