Document Detail


No recurrences in selected patients after curettage with cryotherapy for grade I chondrosarcomas.
MedLine Citation:
PMID:  20054673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The low aggressiveness of Grade I chondrosarcomas is compatible with conservative surgical treatment. QUESTIONS/PURPOSE: We asked whether combined curettage and cryotherapy would yield low rates of recurrence and whether supplemental internal fixation would retain function with low rates of complications in patients with Grade I central chondrosarcomas of the proximal humerus or distal femur.
METHODS: We retrospectively reviewed 15 patients: nine women and six men with a mean age of 45 years (range, 26-70 years). All patients underwent curettage and cryosurgery through a cortical window; we replaced the window and plated the region with at least three screws beyond the curetted area. None of the patients was lost to followup, and 14 patients (93%) were reexamined by us after a minimum of 5 years (mean, 8 years; range, 5-11 years).
RESULTS: There were no perioperative anesthetic, neurologic, hardware, or healing complications. None of the patients had local recurrence or metastases develop. At last followup, the Musculoskeletal Tumor Society score was 27.9 (range, 22-30) and all patients had resumed their previous activities. No complications were associated with this simplified cryotherapy technique.
CONCLUSIONS: The data confirm the appropriateness of conservative surgery for central low-grade chondrosarcomas of the proximal humerus and distal femur based on a combination of intralesional curettage and cryogenic parietal sterilization. Candidates for this approach should be chosen on the basis of the affected bone site, local extension staging, and clinicopathologic grading. We recommend supplementary internal fixation.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Badio S Souna; Nicolas Belot; Hélène Duval; Frantz Langlais; Hervé Thomazeau
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Publication Detail:
Type:  Journal Article     Date:  2010-01-07
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-06-28     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1956-62     Citation Subset:  AIM; IM    
Affiliation:
Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Universitaire de Rennes, 16 Bd de Bulgarie, BP 90347, 35203, Rennes Cedex 2, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bone Neoplasms / pathology,  surgery*
Bone Screws
Chondrosarcoma / pathology,  surgery*
Cryosurgery / methods*
Curettage*
Female
Femur / pathology,  surgery
Humans
Humerus / pathology,  surgery
Hypothermia, Induced
Male
Middle Aged
Neoplasm Recurrence, Local
Retrospective Studies
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