Abstract

Dr. Md. Matiul Islam*, Dr. Md. Hassan Jamil Hedyatullah, Dr. Obaidul Haque

ABSTRACT

Background: Giant cell tumors (GCT) of bone are locally destructive benign entities that occur predominantly in long bones of post-pubertal adolescents and young adults. Most of such cases are treated by aggressive curettage or resection. Occasionally, Giant cell tumors of bone may undergo malignant transformation to undifferentiated sarcomas. We have very limited research-oriented information regarding the GCT management. Aim of the study: The aim of this study was to evaluate the management and outcomes of giant cell tumors (GCT) by aggressive curettage or resection procedure. Methods: This was a prospective observational study which was in the conducted in the Dept. of Orthopaedic & Traumatology, Rajshahiii Medical College & Hospital, Rajshahi, Bangladesh during the period from January 2020 to December2020. In total 26 patients with biopsy proven GCTs were enrolled as the study population. All patients were given one pre-operative and two post-operative doses of zoledronic acid. Extended curettage was done three weeks after the pre-operative dose of zoledronate. The functional status of the patients was assessed MSTS score. All data were processed, analyzed and disseminated by MS Office and SPSS version as per need. Result: In this study needed time to full weight bearing was found up to 12 weeks, up to 16 weeks and up to 20 weeks for 7.69%, 34.62% and 57.69% patients respectively. On the other hand, as complications rejection reaction, EHL weakness, osteoarthritis and joint stiffness was found among 23.08%, 19.23%, 11.54% and 7.69% patients respectively. According to the Musculoskeletal Tumour Society (MSTS) scoring system as final outcome ‘Excellent’, ‘Good’, ‘Moderate’, ‘Fair’ and ‘Poor’ results were found among 38.46%, 26.92%, 15.38%, 11.54% and 7.69% patients respectively. Conclusion: To decrease the recurrence of GCT surgeons use several methods. We think, by not adding cancellous bone graft to the cavity after curettage, with local adjuvant hydrogen peroxide and systemic zoledronic acid to supplement the curettage with power burrs, would decrease the recurrence rates in GCT. Considering short time recovery, low blood loss and minimum complication surgeons can choose curettage and zoledronic acid with structural support by fibula cortical struts in treating GCT.