Comparative Analysis and Evaluation of Functional Outcome of Extended Curettage, Cauterization of Margins with Appropriate Fixation, and Bone Cementing with or without Incorporation of Zoledronic Acid Powder in Grade III Campanacci Giant Cell Tumor Around Knee Joint
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Date
2024-07
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Publisher
International Research Organization for Life & Health Sciences
Abstract
Introduction: Treatment of giant cell tumors (GCT) Campanacci grade III remains challenging till date because of the high recurrence rate of the disease and notorious post-operative complications which lead to significant morbidity in patients. Among the various types of surgical procedures, we chose extended curettage, cauterization of margins followed by appropriate fixation, and bone cementing with and without incorporation of zoledronic acid. This study was conducted to evaluate the functional outcome of the aforementioned procedure. Materials and Methods: A prospective analytical study of 10 patients of grade III Campanacci GCT was included in the study and all patients were planned for surgical intervention and included in this study. The patients were randomly divided into two groups, of which one group was taken for extended curettage, cauterization of margins followed by appropriate fixation with bone cementing alone, and in the other group same procedure was done with the incorporation of zoledronic acid in bone cement. Lysholm scoring was used to evaluate the outcome in follow-up. Results: The mean Lysholm score in the pre-operative period was 0.5, whereas the mean Lysholm score at 6 weeks was 21.5, 74.7 at 12 weeks, and 87.5 at 24 weeks post-operative period. Upon comparison between the mean Lysholm score at 6, 12, and 24 weeks post-operative period in the zoledronic acid application group and zoledronic acid non-application group, it was 21.80 versus 21.20 (P = 0.412), 75 versus 74.40 (P = 0.644), and 89 versus 86 (P = 0.111), respectively. Regarding postoperative complications among the study subjects, a total of 3 patients (30%) developed post-operative complications, among which 2 patients developed swelling (20%) and 1 patient (10%) developed joint pain. Conclusion: Although not statistically significant, there was a trend of better functional outcomes in terms of the Lysholm scoring system in cases of grade III Campanacci GCT around the knee joint treated with extended curettage, cauterization of margins with appropriate fixation, and bone cementing with or without incorporation of zoledronic acid powder
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Keywords
Campanacci grade III giant cell tumor, Zoledronic acid
Citation
Sahu MK, Jain VK, Srivastava P, Jain SN, Baghel P, Parihar GS. Comparative Analysis and Evaluation of Functional Outcome of Extended Curettage, Cauterization of Margins with Appropriate Fixation, and Bone Cementing with or without Incorporation of Zoledronic Acid Powder in Grade III Campanacci Giant Cell Tumor Around Knee Joint. International Journal of Scientific Study. 2024 Jul; 12(4): 55-62