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Review
. 2025 Jan;17(1):295-309.
doi: 10.1111/os.14287. Epub 2024 Nov 7.

Arthroscopic Management of Juxta-Articular Proximal Tibial Chondroblastoma: A Case Report and Literature Review

Cong Xiao  1 , Shaoyun Zhang  1 , Zhixiang Gao  1 , Lifu Wang  1 , Yixin Dai  1 , Jian Li  2
Affiliations
Review

Arthroscopic Management of Juxta-Articular Proximal Tibial Chondroblastoma: A Case Report and Literature Review

Cong Xiao et al. Orthop Surg. 2025 Jan.

Abstract

Background: Chondroblastoma is a rare bone tumor that originates from the epiphysis, constitutes around 1% of all primary bone tumors and is recognized for its tendency to exhibit local invasiveness, as well as the possibility of metastasis and recurrence in nearby areas. Currently, the main surgical treatment for chondroblastoma is open surgery, involving excision of the lesion. There are relatively few reports on arthroscopic surgery for the treatment of chondroblastoma. However, open surgical curettage is associated with operation-related trauma and potential for damage to the osteoepiphysis resulting in growth disturbances.

Case presentation: This case study presents the application of an arthroscopic technique in a 14-year-old male patient with chondroblastoma affecting the proximal tibia and tibial eminence. The procedure involved thorough removal of the lesion using direct visualization with the management of the cavity utilizing a substitute for autologous bone graft. After 1 year of follow-up, the patient remains free from symptoms, exhibits normal knee functionality, and radiographic analysis reveals a good autologous bone graft fusion without any signs of recurrence.

Conclusions: Based on the existing cases of arthroscopic treatment for chondroblastoma and the report of this case, arthroscopic treatment for chondroblastoma can be considered as a specific treatment option for certain patients. In some cases, this technique could be an effective alternative to open surgery.

Keywords: arthroscopy; bone substitute; chondroblastoma; proximal tibial.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Radiographs of right (R) knee showing eccentric juxta‐articular osteolytic lesion in proximal tibial: Anteroposterior (A) and lateral (B) views.
FIGURE 2
FIGURE 2
CT scans and three‐dimensional reconstruction showing osteolytic lesion in proximal tibial physis of right knee: axial view (A); sagittal view (B); coronal view (C); and three‐dimensional reconstruction of the lesion (D).
FIGURE 3
FIGURE 3
Magnetic resonance images of proximal tibial lesion in right knee: coronal T1‐weighted image (A), coronal T2‐weighted image view (B), sagittal T1‐weighted image (C), and sagittal T2‐weighted image (D). A well‐circumscribed septate lesion is seen, consisting of lobules with evidence of neighboring marrow edema.
FIGURE 4
FIGURE 4
Arthroscopic procedures under direct vision: a vascular traction band is utilized to pull the anterior cruciate ligament (A, B); and the location of the lesion in knee (C), the red arrow represents the anterior cruciate ligament, the blue arrow represents the posterior cruciate ligament. The red circle indicates the location of the lesion; the lesion was exposed after soft tissues were cleaned (D).
FIGURE 5
FIGURE 5
Arthroscopic procedures under direct vision: confirmed by probing the lesion area (A), thinned out cortex forming the roof of the lesion (B), complete debridement of tumor tissue is performed and healthy cancellous subchondral bone is reached (C) and graft bone was fitted into the defect and stabilized Kirschner wires (D).
FIGURE 6
FIGURE 6
A shaver with a 90° bent angle was employed in surgery (C). A straight shaver cannot reach the anterior wall of the lesion (A). A shaver with a 90° bent angle can reach the anterior wall of the lesion (B).
FIGURE 7
FIGURE 7
Radiographs of right knee showing a good osteointegration of the bone graft 3 months after surgery: anteroposterior (A) and lateral (B) views.
FIGURE 8
FIGURE 8
The 3‐months follow‐up after surgery demonstrated an excellent functionality of the knee joint: anterior (A) and lateral (B) view.
FIGURE 9
FIGURE 9
CT scan showing at 12 months of follow‐up of a good osteointegration of the bone graft: axial view (A), sagittal view (B), and coronal view (C).
FIGURE 10
FIGURE 10
The 12‐months follow‐up after surgery demonstrated an excellent functionality of the right knee: flexed position of right knee (A) and Crouch of the patient (B).
FIGURE A1
FIGURE A1
The 18F‐FDG PET/CT imaging of patient at our hospital, the SUVmax = 8.1.
FIGURE A2
FIGURE A2
Histopathology showing cobblestone arrangement of chondrocytes on a chondroid matrix.
FIGURE A3
FIGURE A3
Radiographs of right knee 1 month after surgery: anteroposterior (A) and lateral (B) views.
FIGURE A4
FIGURE A4
One month after surgery, the right knee can be extended 0° (A) and flexed 100° (B), with a Lysholm score of 67 for the right knee joint.
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