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Resection-reconstruction arthroplasty for giant cell tumor of distal radius

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Giant cell tumor (GCT) of the distal radius poses problems for reconstruction after resection. Several reconstructive procedures like vascularized and non-vascularized fibular graft, osteo-articular allograft, ceramic prosthesis and megaprosthesis are in use for substitution of the defect in the distal radius following resection. Most authors advocate wrist arthrodesis following resection of distal radius and non vascularized fibular graft. Here we have analyzed the results of aggressive benign GCTs of the distal radius treated by resection and reconstruction arthroplasty using autogenous non-vascularized fibular graft.

Materials and Methods

Twenty-four cases of giant cell tumor of the distal radius (mean age 32 years, mean follow-up 6.6 years) treated by en-bloc resection and reconstruction arthroplasty using autogenous non-vascularized ipsilateral fibular graft with a minimum followup of two years have been included in this retrospective study. Nineteen cases were of Campanacci grade III and five were of Grade II recurrence. The mean resected length of the radius was 9.5 (8-12) cm. Routine radiographs and clinical assessments regarding pain, instability, recurrence, hand grip strength and functional status were done at regular intervals and functional results were assessed using (musculoskeletal tumor society) MSTS-87 scoring.

Results

Early radiological union at host-graft junction was achieved at mean 12.5 weeks, (range 12-14 weeks) and solid incorporation with callus formation was observed in mean 29 weeks (range 28-32 weeks) in all the cases. Satisfactory range of motion (mean 63%, range 52-78%) of the wrist was achieved in 18 cases. Grip strength compared to the contralateral hand was found to be 67% (range 58-74%). Functional results were excellent in six cases (25%), good in 14 cases (58.3%) and four (16.7%) cases had fair results. Soft tissue recurrence was seen in one patient. The most commonly encountered complication was fibulo-carpal subluxation (10 cases, 41.7%).

Conclusion

Resection of the distal radius and reconstruction arthroplasty with non-vascularized proximal fibular graft is useful in preserving the functional movement and stability of the wrist as well as achieving satisfactory range of movement and grip strength.

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References

  1. Eckardt JJ, Grogan TJ. Giant cell tumour of bone. Clin Orthop 1986;204:45–58.

    Google Scholar 

  2. Dahlin DC, Cupps RE, Johnson EW Jr. Giant cell tumour: A study of 195 cases. Cancer 1970;25:1061–70.

    Article  CAS  Google Scholar 

  3. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant cell tumour of bone. An analysis two hundred and eighty cases. J Bone Joint Surg Am 1970;52:619–64.

    CAS  Google Scholar 

  4. Marcove RC, Weis LD, Vaghaiwala MR, Pearson R. Cryosurgery in the treatment of giant cell tumoue of bone - a report of 52 consecutive cases. Cancer 1978;41:957–69.

    Article  CAS  Google Scholar 

  5. Smith RJ, Mankin HJ. Allograft replacement of distal radius for giant cell tumour of distal radius. J Hand Surg Am 1977;2:299–309.

    Article  CAS  Google Scholar 

  6. Rastogi S, Prasanth I, Khan SA, Trikha V, Mittal R. Giant cell tumour of bone: Is curettage the answer? Ind J Orthop 2007;41:109–14.

    Article  Google Scholar 

  7. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant cell tumour of bone. J Bone joint Surg Am 1987;69:106–14.

    Article  CAS  Google Scholar 

  8. Getilis S, Mallin BA, Piaseccki P, Turner F. Intralesional excision compared with en bloc resection for giant cell tumour of bone. J Bone Joint Surg Am 1993;75:1648–55.

    Article  Google Scholar 

  9. McDonald DJ, Sim FH, McLeod RA, Dahlin DC. Giant cell tumour of bone. J Bone Joint Surg Am 1986;68:235–42.

    Article  CAS  Google Scholar 

  10. Vander Griend RA, Funderburk CH. The treatment of giant cell tumour of distal part of the radius. J Bone Joint Surg Am 1993;75:899–908.

    Article  Google Scholar 

  11. Walthar M. Resection de extremite inferieure du radius pour osteosarcoma geffe de I extremite superiuete du perone. Sac Chir Par Bull Mem 1911;37:739–47.

    Google Scholar 

  12. Deb HK, Das NK. Resection and reconstructive surgery in giant cell tumour of bone. Ind J Orthop 1992;26:13–6.

    Google Scholar 

  13. Goni V, Gill SS, Dhillon MS, Nagi ON. Reconstruction of massive skeletal defects after tumour resection. Ind J Orthop 1992;26:13–6.

    Google Scholar 

  14. Aithal VK, Bhaskaranand K. Reconstruction of distal radius following excision of giant cell tumour. Int Orthop 2003;27:110–3.

    Article  CAS  Google Scholar 

  15. Harris WR, Lehmann EC. Recurrent giant cell tumour after en bloc excision of distal radius and fibular autograft replacement. J Bone Joint Surg Br 1983;65:618–20.

    Article  CAS  Google Scholar 

  16. Murray JA, Schlafly B. Giant cell tumours in the distal end of the radius. Treatment by resection and autograft interpositional arthrodesis. J Bone Joint Surg Am 1986;68:687–94.

    Article  CAS  Google Scholar 

  17. Van Demark RE Jr, Van Demark RE Sr. Non-vascularized fibular autograft to treat recurrent giant cell tumour of the distal radius. J Hand Surg Am 1988;13:671–5.

    Article  Google Scholar 

  18. Pho RW. Malignant giant cell tumour of distal end of the radius treated by a free vascularized fibular transplant. J Bone Joint Surg Am 1981;63:877–84.

    Article  CAS  Google Scholar 

  19. Weiland AJ. Vascularized free bone transplants. J Bone Joint Surg Am 1981;63:166–9.

    Article  CAS  Google Scholar 

  20. Intuwongse CS. Reconstruction following resection of a giant cell tumour of distal radius using a vascularized pedicle graft of ulna. J Hand Surg 1998;23:742–7.

    Article  CAS  Google Scholar 

  21. Enneking WF. Modification of system for the functional evaluation of surgical management of musculoskeletal tumours. In: Enneking WF, editor. Limb Salvage in Musculoskeletal Oncology. New York: Churchill Livingstone; 1987. p. 626–39.

    Google Scholar 

  22. Ihara K, Doi K, Sakai K, Yamamoto M, Kanchiku T, Kawai S. Vascularized fibular graft after excision of giant cell tumour ofthe distal radius, a case report. J Surg Oncol 1998;68:100–3.

    Article  Google Scholar 

  23. O’Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gerhart MC, Mankin HJ. Recurrence of giant cell tumours of long bones after curettage and packing with cement. J Bone Joint Surg Am 1994;76:1827–33.

    Article  Google Scholar 

  24. Cheng CY, Shih HN, Hsu KY, Hsu RW. Treatment of giant cell tumour ofthe distal radius. Clin Orthop 2001;383:221–8.

    Article  Google Scholar 

  25. Harness NG, Mankin HJ. Giant cell tumour of the distal forearm. J Hand Surg Am 2004;29:188–93.

    Article  Google Scholar 

  26. Dhamni IK, Jain AK, Maheswari AV, Singh MP. Giant cell tumours ofthe lower end of radius:problemsand solutions. Ind J Orthop 2005;39:201–5.

    Article  Google Scholar 

  27. Lackman RD, McDonald DJ, Beckenbaugh RD, Sim FH. Fibular reconstruction for giant cell tumour of the radius. Clin Orthop 1987;218:232–8.

    Google Scholar 

  28. Saraf SK, Goel SC. Complications of resection and reconstruction in giant cell tumour of distal end of radius- An analysis. Ind J Orthop 2005;39:206–11.

    Article  Google Scholar 

  29. Panchwagh Y, Puri A, Agarwal M, Anchan C, Shah M. Giant cell tumour - distal end radius: Do we know the answer. Ind J Orthop 2007;41:139–45.

    Article  Google Scholar 

  30. Puloski SK, Griffin A, Fergusson PC, Bell RS, Wunder JS. Functional outcome after treatment of aggressive tumours in the distal radius. Clin Orthop Rel Res 2007;459:154–60.

    Article  Google Scholar 

  31. Minami A, Kato H, Iwasaki N. Vascularized fibular graft after excision of giant cell tumour of the distal radius: Wrist arthroplasty versus partial wrist arthrodesis. Plast Reconstr Surg 2002;110:112–7.

    Article  Google Scholar 

  32. Bianchi G, Donati D, Staals EL, Mercury M. Osteoarticular allograft reconstruction of the distal radius after bone tumour resection. J Hand Surg Br 2005;30:369–73.

    Article  CAS  Google Scholar 

  33. Hatano H, Monta T, Kobayashi H, Otsuka H. A ceramic endoprostheses for the treatment of tumours of the distal radius. J Bone Joint Surg Br 2006;88:1656–8.

    Article  CAS  Google Scholar 

  34. Natarajan MV, Bose JC, Viswanath J, Balasubramanium M, Sameer M. Custom prosthetic replacement for distal radius tumours. Int Orthop 2009;33:1081–4.

    Article  Google Scholar 

  35. Tomic S, Krajcinovic O, Krajcinovic J. Illizarov reconstruction of the distal radius after resection of a giant cell tumour: A case report. Clin Orthop Reparatrice Appar Mot 2006;92:264–70.

    Google Scholar 

  36. Asavamongkolkul A, Waikakul S, Phimolsarnti R, Kiatisevi P. Functional outcome following excision of a tumour and reconstruction of distal radius. Int Orthop 2009;33:203–9.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics, Gauhati Medical College, Guwahati, India

    Kabul C. Saikia, Munin Borgohain, Sanjeev K. Bhuyan, Sanjiv Goswami, Aryan Bora & Firoz Ahmed

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  1. Kabul C. Saikia
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  2. Munin Borgohain
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  3. Sanjeev K. Bhuyan
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  4. Sanjiv Goswami
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  5. Aryan Bora
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  6. Firoz Ahmed
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Correspondence to Kabul C. Saikia.

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Saikia, K.C., Borgohain, M., Bhuyan, S.K. et al. Resection-reconstruction arthroplasty for giant cell tumor of distal radius. IJOO 44, 327–332 (2010). https://doi.org/10.4103/0019-5413.65134

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