The Role of Bone Grafting vs. Bone Cement in the Treatment of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis on the Risk of Recurrence in 1,454 Patients.
Joseph P Costello, Levi M Travis, Jacob Jahn, Juan A Pretell-Mazzini
{"title":"The Role of Bone Grafting vs. Bone Cement in the Treatment of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis on the Risk of Recurrence in 1,454 Patients.","authors":"Joseph P Costello, Levi M Travis, Jacob Jahn, Juan A Pretell-Mazzini","doi":"10.2106/JBJS.RVW.24.00080","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Giant cell tumor of bone (GCTB) presents a challenge in management due to its invasive nature and propensity for local recurrence. While either bone grafting (BG) or bone cement (BC) can be utilized to fill defects after intralesional curettage, the optimal treatment remains contested. The purpose of this study was to examine the impact of defect filling with BC compared with BG on recurrence rates in patients with GCTB following intralesional curettage.</p><p><strong>Methods: </strong>A random-effects model binary outcome meta-analysis was performed utilizing recurrence rate for the BC and BG groups to evaluate the risk ratio (p < 0.05 considered significant). There were 1,454 patients included.</p><p><strong>Results: </strong>Intralesional curettage with BG had a recurrence risk ratio of 1.68 (95% confidence interval [CI], 1.22-2.31, p = 0.001) when compared with BC. The overall rate of recurrence for GCTB after intralesional curettage with BC was 20.05% vs. 29.74% with BG (95% CI, 0.17-0.23 vs. 0.26-0.33, p < 0.001).</p><p><strong>Conclusion: </strong>Intralesional curettage with BC for the treatment of GCTB demonstrated lower recurrence rates than intralesional curettage with BG. However, the rates of recurrence remain substantial for both groups, necessitating careful consideration of the benefits and potential pitfalls associated with BC vs. BG when considering salvage options after recurrences.</p><p><strong>Level of evidence: </strong>Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 9","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBJS Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.RVW.24.00080","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Giant cell tumor of bone (GCTB) presents a challenge in management due to its invasive nature and propensity for local recurrence. While either bone grafting (BG) or bone cement (BC) can be utilized to fill defects after intralesional curettage, the optimal treatment remains contested. The purpose of this study was to examine the impact of defect filling with BC compared with BG on recurrence rates in patients with GCTB following intralesional curettage.
Methods: A random-effects model binary outcome meta-analysis was performed utilizing recurrence rate for the BC and BG groups to evaluate the risk ratio (p < 0.05 considered significant). There were 1,454 patients included.
Results: Intralesional curettage with BG had a recurrence risk ratio of 1.68 (95% confidence interval [CI], 1.22-2.31, p = 0.001) when compared with BC. The overall rate of recurrence for GCTB after intralesional curettage with BC was 20.05% vs. 29.74% with BG (95% CI, 0.17-0.23 vs. 0.26-0.33, p < 0.001).
Conclusion: Intralesional curettage with BC for the treatment of GCTB demonstrated lower recurrence rates than intralesional curettage with BG. However, the rates of recurrence remain substantial for both groups, necessitating careful consideration of the benefits and potential pitfalls associated with BC vs. BG when considering salvage options after recurrences.
Level of evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.
骨移植与骨水泥在骨巨细胞瘤治疗中的作用：关于 1454 例患者复发风险的系统性回顾和 Meta 分析》（The Role of Bone Grafting vs. Bone Cement in the Treatment of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis on the Risk of Recurrence in 1,454 Patients）。
背景：骨巨细胞瘤（GCTB）因其侵袭性和局部复发的倾向，给治疗带来了挑战。虽然骨移植（BG）或骨水泥（BC）都可用于填充腔内刮除术后的缺损，但最佳治疗方法仍存在争议。本研究的目的是探讨与 BG 相比，用 BC 填充缺损对腔内刮除术后 GCTB 患者复发率的影响：随机效应模型二元结果荟萃分析利用 BC 组和 BG 组的复发率来评估风险比（P < 0.05 为显著）。共纳入 1454 例患者：与 BC 相比，使用 BG 进行区域内刮除术的复发风险比为 1.68（95% 置信区间 [CI]，1.22-2.31，P = 0.001）。使用 BC 进行腔内刮除后，GCTB 的总复发率为 20.05% vs. 使用 BG 为 29.74% (95% CI, 0.17-0.23 vs. 0.26-0.33, p < 0.001)：结论：在治疗 GCTB 时，使用 BC 进行区域内刮除的复发率低于使用 BG 进行区域内刮除的复发率。然而，两组的复发率仍然很高，因此在考虑复发后的挽救方案时，有必要仔细考虑 BC 与 BG 的相关益处和潜在隐患：证据等级：三级。有关证据级别的完整描述，请参阅 "作者须知"。
期刊介绍：
JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
