Evaluating The Outcome Of Treatment Using Bone Cement Or Bone Graft In Giant Cell Tumour Of Longbone

Introduction:Giant cell tumors exhibit a benign histological picture which has a high potential to show local aggressiveness and has the potency of incidental transformation into sarcoma.Intensive intralesional curettage followed by bone graft or bone cement filling standard method of treatment.We evaluated the outcome of intralesional curettage using bone graft or bone cement by observing event free survival,recurrence,postoperative complications like stiffness,osteoarthritis,fracture during the follow up visits of the patients.Method:In the First affiliated hospital of Zhengzhou University total 105 patients having giant cell tumour of long bone were treated from January 2013 to December 2017.Among them we selected 78 patients who did not have a pathological fracture at the time of diagnosis,no metastasis and came for a post operative scheduled follow up.The patients were divided into 2 groups:Group A who had curettage with bone cement filling and Group B who had curettage with bone graft.Result:39 patients were treated with intralesional curettage followed by bone cement filling and 39 patients were treated with intralesional curettage followed by bone graft Bone cement has been considered to have better complication free survival than bone graft(P=0.001).15 patients treated with bone cement filling developed their complications like local recurrence,fracture,stiffness of joint,osteoarthritis at a mean time of 23.4 months which is significantly higher(with a P=0.02)than 25 patients treated with bone graft who developed complication at a mean time of 12.5 months.The mean time of developing of local recurrence in patients who underwent bone curettage with bone cement filling is 25.2 months whereas in patients with bone graft the mean time for local recurrence is 1 1.4 months is significantly different(P=0.013).Internal fixation along with filling material gives a better prognosis than using the filling material alone(P=0.029).Conclusion:We evaluated that intralesional curettage following bone cement filling has lower recurrence rate and less complications compared to bone graft substitute.The possibility of development of complication becomes less obvious if internal fixator is used along with bone cement.This can be used for prompt and longer duration of complication free survival.