Distraction Osteogenesis After Wide Margin Resection in Campanacci Grade III Giant Cell Tumor of Femur and Tibia

Badaruddin Sahito, Itaat Hussain Zaidi, Suneel Kumar, Dileep Kumar, Noman Parekh, Arsalan Khalil Ayoub, Maratib Ali

Abstract

Objective

To find the effectiveness of distraction osteogenesis with Illizarov after marginal or wide margin resection for giant cell tumor.

Study design

Case series.

Place & Duration of study

Department of Orthopaedic Surgery Dow University of Health sciences / Civil Hospital Karachi, from March 2012 to March 2019.

Methodology

Patients with giant cell tumor grade III who needed marginal or wide margin resection were enrolled in the study. Patients with Grade I and II giant cell tumor, secondary giant cell tumor and tumor with metastasis were excluded.

Results

Ten patients with biopsy proven giant cell tumor with grade III were included in this study. In five patient (50%) tumor was in distal femur, four (40%) proximal tibia and one (10%) in distal tibia. Right side was affected in six patient (60%) and four (40%) were on left side. Marginal and wide margin resection was done in all patients. In all patients bony defect was reconstructed with Illizarov apparatus by bone transport with and without nail. Two patients had retraction of transported bone after Illizarov removal. Additionally bone graft was done in four patients and in patient with distal tibia transport, fixed with T-plate. Consolidation and union were noted in all subjects.  All patients had satisfactory score except one female who had problem with corticotomy.

Conclusions

Distraction osteogenesis for reconstruction of bone defect after wide margin resection of giant cell tumor worked well. This was found cost effective, doable, biological method of reconstruction. With arthodesis limb was saved but with no joint movement.

Key words

Arthodesis, Distraction osteogenesis, Giant cell tumor.