Long‑Term Outcome of Endoprosthetic Replacement for Proximal Femur Giant Cell Tumor

Abstract

Introduction: Giant cell tumor (GCT) of bone is locally aggressive benign tumor involving the epiphysis of long bones in young adults. Various treatment options include intralesional curettage, extended curettage, wide resection, resection and reconstruction and amputation. The main variables to be considered for planning treatment include the site of involvement and Campanacci stage of the tumor. Functional and oncological outcomes of these treatment options vary widely, the predominant detrimental factor being tumor recurrence rate.

Aim: A study was conducted to evaluate the long‑term oncological and functional outcome of patients with GCT of the proximal femur that underwent tumor resection and endoprosthetic replacement.

Materials and Methods: Eleven patients with Campanacci stage‑III GCT of proximal femur who underwent wide excision of tumor and endoprosthesis replacement with a mean follow‑up the duration of 10.6 years were assessed using standard proforma. The treatment outcome was evaluated using the Revised Musculoskeletal Tumor Society Rating Scale for the lower extremity.

Results: At mean follow‑up the duration of 10.6 years, none of the cases had tumor recurrence, infection, prosthesis loosening or dislocation. All the patients were community ambulators among whom eight patients were walking without support while three patients were using a cane for support. The mean total Musculoskeletal Tumor Society Score was 26.8 out of 30 indicating the good outcome.

Conclusions: The authors recommend that wide resection and endoprosthetic replacement should be considered as a preferred treatment option for proximal femur GCT as the functional, and oncological outcome is satisfactory with this modality of treatment.

Keywords: Endoprosthesis megaprosthesis, giant cell tumor of bone, proximal femur