Curettage and acrylic cementation in surgery of giant cell tumors of bone

Abstract

True giant cell tumors of bone (osteoblastomas) are comparatively rare but often large at time of discovery, making the surgical treatment controversial. Simple curettage or resection with bone filling is used when the lesion is small. Resection with arthroplasty or arthrodesis and possibly amputation is used in advanced cases. Thorough curettage with acrylic cementation is presented in a series of 6 cases from Rotterdam and Lund with a follow-up time between 2 and 7 years. The advantages of this method are full and early mobility and stability as well as a simplified postoperative X-ray control, especially when barium sulphate contrast has been added to the acrylic cement. Finally, if this technique is used in cases where more extensive surgery becomes necessary later, there is much to gain and little to lose. The operation may turn out to be the method of choice for this special type of tumor when a simple curettage or resection is no longer possible without loss of function. No recurrences or spread have been observed among these 6 cases. It is suggested that the heat generation could be an advantage of the method.