ArticleBMC musculoskeletal disorders2022
Risk factors of fracture following curettage for bone giant cell tumors of the extremities.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 20 citations in OpenAlex.
- Campanacci stage and cortical destruction predict functional outcomes in giant cell tumor of bone.Irish journal of medical science · 2026Article
- Injectable synthetic bone graft substitute (GeneX) in the surgical management of benign bone tumours: further experience from a tertiary musculoskeletal oncology centre.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Intraoperative Cryotherapy as a Local Adjuvant After Bone Curettage in Orthopedic Oncology: A Review of Modern Literature.Journal of clinical medicine · 2025Review
- The supercritical COBone reports · 2025Article
- Fixation with Carbon Fiber Plates After Curettage in Benign and Locally Aggressive Bone Tumors: Clinical and Radiographic Outcomes.Journal of clinical medicine · 2025Article
- Clinical Outcomes of CurettageRevista brasileira de ortopedia · 2024Article
- Current Concepts in the Treatment of Giant Cell Tumor of Bone: An Update.Current oncology (Toronto, Ont.) · 2024Review
- Postoperative Fracture Risk in Giant Cell Tumor: A Case Report and Review of Literature.Cureus · 2023Article
- Outcome of Reoperation for Local Recurrence Following En Bloc Resection for Bone Giant Cell Tumor of the Extremity.Current oncology (Toronto, Ont.) · 2022Article
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFollowing curettage of giant cell tumor of bone (GCTB), it is common to fill the cavity with polymethylmethacrylate (PMMA) bone cement, bone allograft, or artificial bone to maintain bone strength; however, there is a 2-14% risk of postoperative fractures. We conducted this retrospective study to clarify the risk factors for fractures after curettage for GCTB of the extremities.
methodsThis study included 284 patients with GCTBs of the extremities who underwent curettage at our institutions between 1980 and 2018 after excluding patients whose cavities were not filled with anything or who had additional plate fixation. The tumor cavity was filled with PMMA bone cement alone (n = 124), PMMA bone cement and bone allograft (n = 81), bone allograft alone (n = 63), or hydroxyapatite graft alone (n = 16).
resultsFractures after curettage occurred in 10 (3.5%) patients, and the median time from the curettage to fracture was 3.5 months (interquartile range [IQR], 1.8-8.3 months). The median postoperative follow-up period was 86.5 months (IQR, 50.3-118.8 months). On univariate analysis, patients who had GCTB of the proximal or distal femur (1-year fracture-free survival, 92.5%; 95% confidence interval [CI]: 85.8-96.2) presented a higher risk for postoperative fracture than those who had GCTB at another site (100%; p = 0.0005). Patients with a pathological fracture at presentation (1-year fracture-free survival, 88.2%; 95% CI: 63.2-97.0) presented a higher risk for postoperative fracture than those without a pathological fracture at presentation (97.8%; 95% CI: 95.1-99.0; p = 0.048). Patients who received bone grafting (1-year fracture-free survival, 99.4%; 95% CI: 95.7-99.9) had a lower risk of postoperative fracture than those who did not receive bone grafting (94.4%; 95% CI: 88.7-97.3; p = 0.003).
conclusionsFor GCTBs of the femur, especially those with pathological fracture at presentation, bone grafting after curettage is recommended to reduce the risk of postoperative fracture. Additional plate fixation should be considered when curettage and cement filling without bone grafting are performed in patients with GCTB of the femur. This should be specially performed for those patients with a pathological fracture at presentation.
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