Turn down distal femoral autograft in proximal tibia defect reconstruction - a case report.pdf

  • H.O Obiegbu
Keywords: giant cell tumor, autograft, benign growth, femur, proximal tibia


Giant cell tumor, a benign growth with
aggressive attributes with potential for
both local invasion and recurrence often
affects the proximal tibia with
attendant bone expansion, destruction
and invasion of the articular margin. I
present a 42 year old woman who came
in with a history of a two year old mass
involving the right proximal tibia, and a
week history of bleeding from an
incision scar on the proximal tibia. X-ray
/ histopathological findings revealed an
aggressive giant cell tumor with a
breach of the posterior cortex of the
proximal tibia. The patient was
counselled for surgery, and
subsequently had a resection of the
entire proximal tibia in the first surgery;
and a turn down autograft of the distal
femur with arthrodesis of the knee joint
done in the second surgery. On follow
up for one year, there were no signs of
tumor recurrence and patient could
ambulate comfortably with a walking


1. Van der Hayden l, Van de Sander
MA, Heineken AC, Fiocco M,
Nelissen RG, Djikstra PD. Midterm
outcome after curettage with
polymethylymethacrylate for giant
cell tumor around the knee: higher
risk of radiographic osteoarthritis? J
Bone Joint Surg Am. 2013;
2. Klenke FM, Wenger DE, Inwards CY,
Rose PS, Sim FH. Giant cell tumor of
bone: risk factors for recurrence. Clin
Orthop Relat Res. 2011; 469(2): 591-
3. Niu X, Zhang Q, Hao L, Ding Y, Li Y,
Xu H et al. Giant cell tumor of the
extremity: retrospective analysis of
621 Chinese patients from one
institution. J Bone Joint Surg Am.
2012;94: 461-467
4. Racano A, Pazionis T, Farrokhyar F,
Deheshi B, Ghert M. High infection
rate outcomes in long-bone tumor
surgery with endoprosthetic
reconstruction in adults: a
systematic review. Clin Orthop Relat
Res. 2013; 471: 2017-2027
5. Medellin MR, Fiyiwara t, Tillman RM,
Jeys LM, Gregory J, Stevenson JD et
al. Prognostic factors for local
recurrence in extremity-located
giant cell tumors of bone with
pathological fracture. Bone Joint J.
2018; 100(12): 1626-1632
6. Grimmer RJ, Aydin BK, WafaH, Carter
SR, Jeys L, Abudu A et al. Very long
term outcomes after endoprosthetic
replacement for malignant tumors of
bone. Bone Joint J. 2016; 98: 857-
7. Xu XC, Xu M, Song RX, Fu ZH, Liu XP.
Long term outcome of giant cell
tumors of bone around the
kneetreated by en bloc resection of
tumor and reconstruction with
prosthesis. Orthop Surg. 2010; 2(3):
8. Campanacci M, Giunti A, Olmi R.
Giant cell tumors of bone: A study of
209 cases with long term follow up.
Ital J Orthop Traumatol. 1975; 1:
9. Prosser GH, Baloch KG, Tillman RM,
Carter SR, Grimer RJ. Does curettage
without adjuvant therapy provide
low recurrence rates in giant cell
tumors of bone? Clin Orthop Relat
Res. 2005; 435: 211-218
10. Wang H, Wan N, Hu Y. Giant cell
tumor of bone: a new evaluating
system is necessary. Int Orthop.
2012; 36(12): 2521-2527
11. Morri T, Yabe H, Morioka H, Suzuki
Y, Anazawa U, Toyama Y. Curettage
and allograft reconstruction for giant
cell tumors. J Orthop Surg. 2018; 16:
12. Gaston CL, Goulding K, Grimer RJ.
The use of endoprosthesis in
musculoskeletal oncology. Oper
Tech Orthop. 2014; 24: 91-102
13. Shehadeh A, Noveau J, Malawer M,
Henshaw R. Late complication and
survival of endoprosthetic
reconstruction after resection of
bone tumors. Clin Orthop. 2010;
468(11): 2885-95
14. Ercolano LB, Christensen T,
McGough R, Weiss K. Treatment
solutions are unclear for perimegaprosthetic infections. Clin
Orthop. 2013; 471(10): 3204-13
15.Borzunor D, Baker P, Korshik N.
Reconstruction by bone transport
after resection of benign tumors of
the tibia: a retrospective study of 38
patients. Indian J Orthop. 2015;
49(5): 516-52

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print ISSN: 2141-162X