Clinical observation of expanded curettage in treatment of chondroblastoma_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Qing , LUO Wei , ZHANG Can , LIAO Zhan , WAN Jun , LIU Yupeng ,  HE Hongbo

Department of Orthopedics, Xiangya Hospital, Central South University, Changsha Hunan, 410008, P.R.China;

Corresponding author：

HE Hongbo, Email: jonson8920@sina.com

Keywords：

Chondroblastoma; expanded curettage; joint function

DOI：

10.7507/1002-1892.201706068

Video：

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Objective To explore the effectiveness of expanded curettage in the treatment of chondroblastoma. Methods The clinical data of 37 patients with chondroblastoma who were treated with expanded curettage between January 2011 and May 2016 were retrospectively analyzed. There were 24 males and 13 females, with a median age of 17 years (range, 12-30 years). There were 32 primary patients and 5 recurrent patients. Local pain was the first symptom in all patients. The average disease duration was 4.9 months (range, 2-8 months). The lesions were located in the distal femur in 10 cases, the proximal femur in 7 cases, the proximal tibia in 9 cases, the proximal humerus in 5 cases, the patella in 2 cases, the talus in 1 case, the calcaneus in 1 case, and pelvis in 2 cases. According to the Enneking staging of benign bone tumors, all tumors were rated as the 3rd stage. The length of the lesion ranged from 1.2 to 6.9 cm (mean, 3.2 cm). The lesions involved the epiphyseal plate in 19 cases. Results All incisions healed by first intention, and no complications occurred. All patients were followed up 12-76 months, with an average of 40.5 months. At last follow-up, the Musculoskeletal Tumor Society (MSTS) score was 27.5±1.4, and the difference was significant when compared with pre-operative value (18.5±1.9) (t=23.462, P=0.000). The chondroblastoma recurred in 1 case (2.7%) after 5 months. X-ray film showed that bone resorption was found in 6 cases, but there was no obvious collapse in the articular surface of bone graft. The limb shortening deformity occurred in 3 cases who were epiphyseal plate involvement patients and lesions located around the knee joint. But there was no varus deformity, and knee joint activity was not affected. Conclusion Expanded curettage has advantages of low incidence of recurrence and skeletal deformity, good limb function, and it is one of the ideal options for chondroblastoma.

Citation： LIU Qing, LUO Wei, ZHANG Can, LIAO Zhan, WAN Jun, LIU Yupeng, HE Hongbo. Clinical observation of expanded curettage in treatment of chondroblastoma. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(12): 1438-1441. doi: 10.7507/1002-1892.201706068 Copy

1.	Springfield DS, Capanna R, Gherlinzoni F, et al. Chondroblastoma. A review of seventy cases. J Bone Joint Surg (Am), 1985, 67(5): 748-755.
2.	Dahlin DC, Ivins JC. Benign chondroblastoma. A study of 125 cases. Cancer, 1972, 30(2): 401-413.
3.	Schajowicz F, Gallardo H. Epiphysial chondroblastoma of bone. A clinico-pathological study of sixty-nine cases. J Bone Joint Surg (Br), 1970, 52(2): 205-226.
4.	Strong DP, Grimer RJ, Carter SR, et al. Chondroblastoma of the femoral head: management and outcome. Int Orthop, 2010, 34(3): 413-417.
5.	Garin IE, Wang EH. Chondroblastoma. J Orthop Surg (Hong Kong), 2008, 16(1): 84-87.
6.	Lin PP, Thenappan A, Deavers MT, et al. Treatment and prognosis of chondroblastoma. Clin Orthop Relat Res, 2005, (438): 103-109.
7.	de Silva MV, Reid R. Chondroblastoma: varied histologic appearance, potential diagnostic pitfalls, and clinicopathologic features associated with local recurrence. Ann Diagn Pathol, 2003, 7(4): 205-213.
8.	De Mattos CB, Angsanuntsukh C, Arkader A, et al. Chondroblastoma and chondromyxoid fibroma. J Am Acad Orthop Surg, 2013, 21(4): 225-233.
9.	Hsu CC, Wang JW, Chen CE, et al. Results of curettage and high-speed burring for chondroblastoma of the bone. Chang Gung Med J, 2003, 26(10): 761-767.
10.	Lehner B, Witte D, Weiss S. Clinical and radiological long-term results after operative treatment of chondroblastoma. Arch Orthop Trauma Surg, 2011, 131(1): 45-52.
11.	Ramappa AJ, Lee FY, Tang P, et al. Chondroblastoma of bone. J Bone Joint Surg (Am), 2000, 82-A(8): 1140-1145.
12.	Gouin F, Rochwerger AR, Di Marco A, et al. Adjuvant treatment with zoledronic acid after extensive curettage for giant cell tumours of bone. Eur J Cancer, 2014, 50(14): 2425-2431.
13.	Algawahmed H, Turcotte R, Farrokhyar F, et al. High-Speed Burring with and without the Use of Surgical Adjuvants in the Intralesional Management of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis. Sarcoma, 2010, 2010: 1-5.
14.	Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. 1980. Clin Orthop Relat Res, 2003, (415): 4-18.
15.	Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical-treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res, 1993, (286): 241-246.
16.	Zhang K, Gao Y, Dai H, et al. Chondroblastoma of the talus: a case report and literature review. J Foot Ankle Surg, 2012, 51(2): 262-265.
17.	Ushigome S, Takakuwa T, Shinagawa T, et al. Ultrastructure of cartilaginous tumors and S-100 protein in the tumors. With reference to the histogenesis of chondroblastoma, chondromyxoid fibroma and mesenchymal chondrosarcoma. Acta Pathol Jpn, 1984, 34(6): 1285-1300.
18.	Xu H, Nugent D, Monforte HL, et al. Chondroblastoma of bone in the extremities: a multicenter retrospective study. J Bone Joint Surg (Am), 2015, 97(11): 925-931.
19.	Huvos AG, Marcove RC. Chondroblastoma of bone. A critical review. Clin Orthop Relat Res, 1973, (95): 300-312.
20.	Jaffe HL, Lichtenstein L. Benign Chondroblastoma of Bone: A Reinterpretation of the So-Called Calcifying or Chondromatous Giant Cell Tumor. Am J Pathol, 1942, 18(6): 969-991.
21.	鱼锋, 张清, 郝林, 等. 软骨母细胞瘤 65 例临床分析. 中国骨肿瘤骨病, 2008, 7(4): 208-210.
22.	Sailhan F, Chotel F, Parot R. Chondroblastoma of bone in a pediatric population. J Bone Joint Surg (Am), 2009, 91(9): 2159-2168.
23.	Suneja R, Grimer RJ, Belthur M, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Joint Surg (Br), 2005, 87(7): 974-978.
24.	Tamura M, Oda M, Matsumoto I, et al. Chondroblastoma with pulmonary metastasis in a patient presenting with spontaneous bilateral pneumothorax: Report of a case. Surg Today, 2011, 41(10): 1439-1441.

1. Springfield DS, Capanna R, Gherlinzoni F, et al. Chondroblastoma. A review of seventy cases. J Bone Joint Surg (Am), 1985, 67(5): 748-755.
2. Dahlin DC, Ivins JC. Benign chondroblastoma. A study of 125 cases. Cancer, 1972, 30(2): 401-413.
3. Schajowicz F, Gallardo H. Epiphysial chondroblastoma of bone. A clinico-pathological study of sixty-nine cases. J Bone Joint Surg (Br), 1970, 52(2): 205-226.
4. Strong DP, Grimer RJ, Carter SR, et al. Chondroblastoma of the femoral head: management and outcome. Int Orthop, 2010, 34(3): 413-417.
5. Garin IE, Wang EH. Chondroblastoma. J Orthop Surg (Hong Kong), 2008, 16(1): 84-87.
6. Lin PP, Thenappan A, Deavers MT, et al. Treatment and prognosis of chondroblastoma. Clin Orthop Relat Res, 2005, (438): 103-109.
7. de Silva MV, Reid R. Chondroblastoma: varied histologic appearance, potential diagnostic pitfalls, and clinicopathologic features associated with local recurrence. Ann Diagn Pathol, 2003, 7(4): 205-213.
8. De Mattos CB, Angsanuntsukh C, Arkader A, et al. Chondroblastoma and chondromyxoid fibroma. J Am Acad Orthop Surg, 2013, 21(4): 225-233.
9. Hsu CC, Wang JW, Chen CE, et al. Results of curettage and high-speed burring for chondroblastoma of the bone. Chang Gung Med J, 2003, 26(10): 761-767.
10. Lehner B, Witte D, Weiss S. Clinical and radiological long-term results after operative treatment of chondroblastoma. Arch Orthop Trauma Surg, 2011, 131(1): 45-52.
11. Ramappa AJ, Lee FY, Tang P, et al. Chondroblastoma of bone. J Bone Joint Surg (Am), 2000, 82-A(8): 1140-1145.
12. Gouin F, Rochwerger AR, Di Marco A, et al. Adjuvant treatment with zoledronic acid after extensive curettage for giant cell tumours of bone. Eur J Cancer, 2014, 50(14): 2425-2431.
13. Algawahmed H, Turcotte R, Farrokhyar F, et al. High-Speed Burring with and without the Use of Surgical Adjuvants in the Intralesional Management of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis. Sarcoma, 2010, 2010: 1-5.
14. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. 1980. Clin Orthop Relat Res, 2003, (415): 4-18.
15. Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical-treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res, 1993, (286): 241-246.
16. Zhang K, Gao Y, Dai H, et al. Chondroblastoma of the talus: a case report and literature review. J Foot Ankle Surg, 2012, 51(2): 262-265.
17. Ushigome S, Takakuwa T, Shinagawa T, et al. Ultrastructure of cartilaginous tumors and S-100 protein in the tumors. With reference to the histogenesis of chondroblastoma, chondromyxoid fibroma and mesenchymal chondrosarcoma. Acta Pathol Jpn, 1984, 34(6): 1285-1300.
18. Xu H, Nugent D, Monforte HL, et al. Chondroblastoma of bone in the extremities: a multicenter retrospective study. J Bone Joint Surg (Am), 2015, 97(11): 925-931.
19. Huvos AG, Marcove RC. Chondroblastoma of bone. A critical review. Clin Orthop Relat Res, 1973, (95): 300-312.
20. Jaffe HL, Lichtenstein L. Benign Chondroblastoma of Bone: A Reinterpretation of the So-Called Calcifying or Chondromatous Giant Cell Tumor. Am J Pathol, 1942, 18(6): 969-991.
21. 鱼锋, 张清, 郝林, 等. 软骨母细胞瘤 65 例临床分析. 中国骨肿瘤骨病, 2008, 7(4): 208-210.
22. Sailhan F, Chotel F, Parot R. Chondroblastoma of bone in a pediatric population. J Bone Joint Surg (Am), 2009, 91(9): 2159-2168.
23. Suneja R, Grimer RJ, Belthur M, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Joint Surg (Br), 2005, 87(7): 974-978.
24. Tamura M, Oda M, Matsumoto I, et al. Chondroblastoma with pulmonary metastasis in a patient presenting with spontaneous bilateral pneumothorax: Report of a case. Surg Today, 2011, 41(10): 1439-1441.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical observation of expanded curettage in treatment of chondroblastoma

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