Indian Journal of Orthopaedics

LETTER TO EDITOR
Year
: 2012  |  Volume : 46  |  Issue : 3  |  Page : 373-

Gorham's disease of femur - A response


Sujit Kumar Tripathy1, Ramesh Kumar Sen2, Tarun Goyal3,  
1 Department of Orthopaedics, Friarage Hospital, Northallerton, United Kingdom
2 Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne, United Kingdom

Correspondence Address:
Sujit Kumar Tripathy
Clinical Fellow, Department of Orthopaedics, Northallerton, DL6 1JG
United Kingdom




How to cite this article:
Tripathy SK, Sen RK, Goyal T. Gorham's disease of femur - A response .Indian J Orthop 2012;46:373-373


How to cite this URL:
Tripathy SK, Sen RK, Goyal T. Gorham's disease of femur - A response . Indian J Orthop [serial online] 2012 [cited 2020 Feb 22 ];46:373-373
Available from: http://www.ijoonline.com/text.asp?2012/46/3/373/96372


Full Text

Sir,

We read with great interest the manuscript entitled "Gorham's disease of femur," by Baba et al. [1] There is still no clear consensus about the treatment of Gorham's disease as it shows variable response to medical and surgical treatment.

In 2009, we published our report on treatment of diaphyseal Gorham's disease with radiotherapy and fibular graft. [2] We had similar belief as that of the authors that radiotherapy converts the proliferating blood vessels to fibrous tissue. Subsequent fibular graft transplantation into the defect results in good incorporation. In our previously published article, we reported about the successful transplantation of a fibular graft after radiation therapy in a case of radial diaphysis Gorham's disease in a 15-year-old girl who had a followup of 2 years at that time. [2] But unfortunately, we noticed the recurrence of the disease after 5 years of surgery and the fibular graft in her case showed resorption. It is quite difficult to predict when the disease process actually ceases its activity in Gorham's disease. In our case whether it was a recurrence or it was because of residual disease pathology at that site is quite difficult to say. Whatever may be the cause of resorption of the fibular graft in our case, we would like to say that the followup of the patient (2 years) in the article of Baba et al. is quite short to predict the outcome. We, from our own experience, would like to suggest the authors that they should follow their patient for a long time to have definite conclusion about the outcome of radiation treatment in Gorham's disease. We still believe that the response to treatment is quite variable and unpredictable in Gorham's disease. Long term outcome of all patients treated till date with different procedures must be reported to have better understanding about the disease and its treatment.

References

1Baba AN, Bhat YJ, Palijor SD, Nazir A, Khan NA. Gorham's disease of femur. Indian J Orthop 2011;45:565-8.
2Tripathy SK, Sen RK, Agarwal A. Fibular grafting in diaphyseal Gorham's disease: Report of two cases and review of literature. Eur J Orthop Surg Traumatol 2009;19:485-90.