MODULAR HINGED LONG-STEM KNEE ENDOPROSTHESIS (MEGAPROSTHESIS) IN THE TREATMENT OF LEFT PROXIMAL TIBIAL GIANT CELL TUMOR: A CASE REPORT AND LITTERATURE REVIEW

Dang Phu Liem1, Duong Khai1, Nguyen Tam Tu1, Nguyen Van Het1, Nguyen Thanh Huy1, Huynh Kim Hieu2,
1 Center for Trauma and Orthopedics, Can Tho Central General Hospital
2 Department of Orthopedics, Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Objective: To present a case involving the surgical treatment of a left proximal tibial giant cell tumor with wide resection and reconstruction using a modular hinged long-stem knee prosthesis, and to assess the treatment outcomes after six months of follow-up. Methods: This is a single case study involving a patient with giant cell tumor of the left proximal tibia who underwent wide resection and reconstruction with a modular hinged long-stem knee prosthesis. The patient was followed up for six months at the Arthroplasty and Orthopedic Oncology Department, Center for Trauma and Orthopedics of Can Tho Central General Hospital, from January 2024 to June 2024. Results: The case demonstrates the importance of wide resection in tumor management. Reconstruction with a modular hinged long-stem knee prosthesis effectively reduces the risk of tumor recurrence, mitigates the potential for secondary osteoarthritis, and minimizes complications related to joint fusion. This approach also has the potential to lower treatment costs and shorten hospital stays. Conclusion: Long-stem hinged implants in total knee arthroplasty help prevent bone loss and improve function. Wide local excision with long-stem hinged modular prosthesis can effectively treat proximal tibial giant cell tumors and reduce recurrence.

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References

1. Wheeless, C.R., Wheeless' textbook of orthopaedics. 2001.
2. Karpik, M., Giant Cell Tumor (tumor gigantocellularis, osteoclastoma)-epidemiology, diagnosis, treatment. Ortopedia, traumatologia, rehabilitacja, 2010. 12(3): p. 207-215.
3. Mendenhall, W.M., et al., Giant cell tumor of bone. American journal of clinical oncology, 2006. 29(1): p. 96-99.
4. Thomas, D.M. and K.M. Skubitz, Giant cell tumour of bone. Current opinion in oncology, 2009. 21(4): p. 338-344.
5. Bickels, J. and J.C. Wittig, Operative techniques in orthopaedic surgical oncology. 2012: Lippincott Williams & Wilkins.
6. Pala, E., et al., Megaprosthesis of the knee in tumor and revision surgery. Acta Biomed, 2017. 88(2s): p. 129-138.
7. Mittermayer, F., et al., Revision of the Kotz type of tumour endoprosthesis for the lower limb. J Bone Joint Surg Br, 2002. 84(3): p. 401-6.
8. Ruggieri, P., et al., Long term results of fixed-hinge megaprostheses in limb salvage for malignancy. Knee, 2012. 19(5): p. 543-9.
9. Kotz, R., The development of a modular tumor endoprosthesis (KMFTR-HMRS-GMRS). Evolution, results and perspectives. Arch Ortop Reum, 2005. 116: p. 9-11.
10. 10. Tsukamoto, S., et al., Current Concepts in the Treatment of Giant Cell Tumors of Bone. Cancers (Basel), 2021. 13(15).
11. Parvizi, J., High yield orthopaedics E-Book. 2010: Elsevier Health Sciences.
12. Murphey, M.D., et al., From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation. Radiographics, 2001. 21(5): p. 1283-309.
13. Pitsilos, C., et al., Treatment of Recurrent Giant Cell Tumor of Bones: A Systematic Review. Cancers (Basel), 2023. 15(13).
14. Patil, V.E., S. Mankar, and P. Agrawal, Limb Reconstruction Using the Ilizarov Technique Following Giant Cell Tumour Excision in the Proximal Tibia of a 19-Year-Old Female: A Case Report. Cureus, 2024. 16(4): p. e57434.
15. Gharpinde, M.R., et al., Successful Surgical Management of a Giant Cell Tumor in the Proximal Tibia: A Case Report. Cureus, 2024. 16(4): p. e59173.
16. Bayram, S., et al., What factors are associated with osteoarthritis after cementation for benign aggressive bone tumor of the knee joint: a systematic review and meta-analysis. EFORT Open Rev, 2024. 9(3): p. 181-189.
17. Dũng, T.T., et al., Thay khớp gối điều trị ung thư xương vùng lồi cầu xương đùi ở trẻ em nhân 2 trường hợp. Tạp chí Nghiên cứu Y học, 2020. 128(4): p. 43-50.
18. Kafchitsas, K., et al., Functional results after giant cell tumor operation near knee joint and the cement radiolucent zone as indicator of recurrence. Anticancer Res, 2010. 30(9): p. 3795-9.
19. Errani, C., et al., Giant cell tumor of the extremity: A review of 349 cases from a single institution. Cancer Treat Rev, 2010. 36(1): p. 1-7.
20. 20. He, H., et al., Surgical Treatment Options for Giant Cell Tumors of Bone Around the Knee Joint: Extended Curettage or Segmental Resection? Front Oncol, 2019. 9: p. 946.