SYMPOSIUM - GIANT CELL TUMOR
Year : 2007 | Volume
: 41 | Issue : 2 | Page : 134--138
Management of juxta articular giant cell tumors around the knee by custom mega prosthetic arthroplasty
Mayil Vahanan Natarajan1, R Prabhakar1, M Mohamed Sameer1, RA Shashidhar2
1 Department of Orthopedic Surgery, Madras Medical College and Govt. General Hospital, Chennai - 600 003, India
2 M. N. Orthopedic Hospital, Chennai, India
Background: Juxtaarticular giant cell tumors around the knee are common and pose a special problem of reconstruction after tumor excision. This article analyzes the functional outcome after resection of juxtaarticular giant cell tumors around the knee and replacement by custom mega prosthetic arthroplasty.
Materials and Methods: One hundred and forty-three patients with juxtaarticular giant cell tumors around the knee with mean age of 30.8 years (range 15 to 64 years) underwent resection and replacement by custom mega prosthetic arthroplasty during the period 1994 to 2005. Eighty-one patients were males and 62 were females. Fourteen patients were in Enneking Stage 2 while 129 patients were in Stage 3. Distal femur was involved in 87 patients and proximal tibia in 56 patients. Forty patients presented with pathological fracture at the time of diagnosis. The technique of sleeve resection of the quadriceps musculature was followed to achieve local clearance in distal femoral tumors, and for proximal tibial lesions resection of the tumor-bearing part and a medial gastronemius rotation flap was used routinely. The prosthesis used was a rotating hinge custom mega prosthesis manufactured locally.
Results: The mean follow-up was 5.4 years (1.5 years to 11 years). Functional results were analyzed using Enneking criteria. Excellent results were obtained in 90 patients (62%) and 39 patients had good (27%) results. Periprosthetic fracture (8.3%) and infection (6.9%) were the most common complications followed by aseptic loosening (4.2%). Recurrence of lesion was found in only one patient (0.69%) who was managed with wide local excision.
Conclusion: Custom mega prosthetic arthroplasty is effective in achieving the desired goals of reconstruction with good functional results and least complications in selected patients.
Mayil Vahanan Natarajan
4, Lakshmi Street, Kilpauk, Chennai - 600 010
|How to cite this article:|
Natarajan MV, Prabhakar R, Mohamed Sameer M, Shashidhar R A. Management of juxta articular giant cell tumors around the knee by custom mega prosthetic arthroplasty.Indian J Orthop 2007;41:134-138
|How to cite this URL:|
Natarajan MV, Prabhakar R, Mohamed Sameer M, Shashidhar R A. Management of juxta articular giant cell tumors around the knee by custom mega prosthetic arthroplasty. Indian J Orthop [serial online] 2007 [cited 2019 Jun 16 ];41:134-138
Available from: http://www.ijoonline.com/article.asp?issn=0019-5413;year=2007;volume=41;issue=2;spage=134;epage=138;aulast=Natarajan;type=0