Bone cement in the management of cystic tumour defects of bone at National Orthopaedic Hospital, Igbobi, Lagos

Abstract

Cystic bony defects are characteristics of bone tumours especially benign ones e.g. Giant cell tumours of bone [GCT] and some metastatic tumours to bone. These patients present late with significant cystic cavities at a time the cost and availability of prosthetic implants to replace these defects sometimes precludes resection. The objective of this study is to evaluate the outcome of filling these defects with bone cement augmented with plate and screwfor stability. Aseven year prospective study was carried out in patients presenting with large cystic bony defects secondary to bone tumours at the oncology unit of the National Orthopaedic Hospital, Igbobi, Lagos. Data such as age, sex, anatomic location of lesions, histological type of tumours, x- ray findings, operation performed with the number of packets of bone cement used to fill the resultant bony defects were retrieved from prepared proforma. The average follow-up was 36 months. The proximal tibia and distal femur accounted for 42.9%and 28.6% respectively of the 14 patients studied.Giant cell tumour was the most common histological diagnosis 78.6%]. Bone cement was effective in meeting the local requirements of limb salvage, early functional recovery and as a temporising measure until the patients can avail themselves of better options.The complication encounteredwas that of anaphylactic reaction in 2 scrub nurses. Bone cement augmented with appropriate implants has proven valuable as a stop gap in filling large cystic bony defects resulting fromtumours.

Keywords: Cystic bony defects, bone cement, implant, limb salvage.