Does the addition of cement improve the rate of local recurrence after curettage of giant cell tumours in bone?
Does the addition of cement improve the rate of local recurrence after curettage of giant cell tumours in bone?
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DOI：
10.1302/0301-620x.93b12.27663
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发表时间：
2011-12-01
影响因子：
--
通讯作者：
Grimer, R. J.
中科院分区：
文献类型：
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作者：
Gaston, C. L.;Bhumbra, R.;Grimer, R. J.
我们回顾性地比较了骨巨细胞瘤单独刮除和辅助骨胶结治疗后的结果。1975年至2008年间，330例巨细胞瘤患者主要通过病灶内刮除治疗，其中84例（25%）在腔内接受骨水泥辅助治疗。单纯刮除的局部复发率为29.7%（246例中有73例），而刮除加骨水泥的局部复发率为14.3%（84例中有12例）（p = 0.001）。在多变量分析中，疾病分期和骨水泥的使用是与局部复发相关的独立显著因素。骨水泥的使用与随后需要关节置换术的高风险相关。在没有局部复发的患者中，有骨水泥的患者中有18.1%（72人中有13人）需要进行后续关节置换术，而没有骨水泥的患者中有2.3%（173人中有4人）需要进行后续关节置换术（p = 0.001）。在局部复发的患者中，75.0%（9 / 12）有骨水泥的患者需要关节置换术，而45.2%（33 / 73）没有骨水泥的患者需要关节置换术（p = 0.044）。
We retrospectively compared the outcome after the treatment of giant cell tumours of bone either with curettage alone or with adjuvant cementation. Between 1975 and 2008, 330 patients with a giant cell tumour were treated primarily by intralesional curettage, with 84 (25%) receiving adjuvant bone cement in the cavity. The local recurrence rate for curettage alone was 29.7% (73 of 246) compared with 14.3% (12 of 84) for curettage and cementation (p = 0.001). On multivariate analysis both the stage of disease and use of cement were independent significant factors associated with local recurrence. The use of cement was associated with a higher risk of the subsequent need for joint replacement. In patients without local recurrence, 18.1% (13 of 72) of those with cement needed a subsequent joint replacement compared to 2.3% (4 of 173) of those without cement (p = 0.001). In patients who developed local recurrence, 75.0% (9 of 12) of those with previous cementation required a joint replacement, compared with 45.2% (33 of 73) of those without cement (p = 0.044).