Long-Term Outcome of Custom-Made Megaprosthetic reconstruction in Recurrent Distal Femoral Giant Cell Tumours: A Case Series
Vol 06 Issue 1 | January 2025 | page: 14-17 | Basanta Kumar Behera, Abhay Tyagi, Sumit Kaushik, Akshay Maharia
DOI: https://doi.org/10.13107/ojot.2025.v06.i01.66
Received 29/03/2024; Reviewed 24/04/2025; Accepted 11/10/2025; Published 10/01/2025
Authors: Basanta Kumar Behera [1], Abhay Tyagi [1], Sumit Kaushik [1], Akshay Maharia [1]
[1] Department of Orthopaedics, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India
Address of Correspondence
Dr. Abhay Tyagi,
Department of Orthopaedics, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India
Email ID: abhay20tyagi@gmail.com
Abstract
Giant cell tumours (GCT)s which are benign do exhibits local aggressive behaviour and has propensity for recurrence specially when managed with intralesional curettage. Recurrent lesions, specially in weight bearing regions pose a reconstructive challenge. Mega prosthetic reconstruction following wide excision offers limb salvage with early mobilisation but long-term follow-ups and outcomes are reported rarely.
This case includes five patients with recurrent Campanacci grade 3 distal femoral GCTs treated between 2008 and 2013 after prior intralesional curettage with cementing elsewhere All were managed with wide excision and reconstruction with custom-made megaprosthesis from Eagle Osteon Technologies.
The mean follow was 15 years (range 11.5 to 17.8 years), with excellent Musculoskeletal Tumor Society scores (MSTS) at 10-year follow-up averaging 26.25 (87.5%; range 24-29). No aseptic loosening occurred; one patient developed infection requiring knee arthrodesis, and another had late recurrence at 12 years post-reconstruction. This case series aims to showcase the need of long-term follow-ups and not neglecting patients treated with megaprostheses for recurrent GCT even beyond 10 years of follow-up.
Keywords: Giant Cell Tumour, Distal Femur, Megaprosthesis, Tumour Recurrence, Long-Term Follow-Up
References
1. Macwan AA, Nanda SN, Mishra D, Tuteja S, Sandeep B. A Giant Cell Tumor of the Distal Femur Managed by Excision and Knee Arthrodesis Using a Custom-made Long Intramedullary Interlocking Nail: A Case Report and Review of the Literature. Cureus [Internet]. 2021 May 2 [cited 2025 May]; Available from: https://doi.org/10.7759/cureus.14810
2. Behera KC, Singla M, Yadav U, KP M, Shukla T, Gupta A, et al. A Tertiary Care Centre Experience of Recurrent Giant Cell Tumor Around the Knee Joint. Cureus [Internet]. 2022 Sep 30 [cited 2025 Apr]; Available from: https://doi.org/10.7759/cureus.29788
3. Rigollino AV, Fernando TS, Tanaka MH, Souza MM de. Giant cell tumor locally advanced around the knee: treatment and literature review. Revista Brasileira de Ortopedia (English Edition) [Internet]. Brazilian Society of Orthopedics and Traumatology; 2017 Jun 1 [cited 2025 May];52(4):473. Available from: https://doi.org/10.1016/j.rboe.2017.06.009
4. Popescu MJ, Stoicea MC, Marinescu I, Cismaşiu RS, Stovicek PO, Tudose C, et al. Depression and anxiety in recurrent giant cell tumor of bone. Romanian Journal of Morphology and Embryology [Internet]. 2021 Jun 25 [cited 2025 May];61(4):1057. Available from: https://doi.org/ 10.47162/rjme.61.4.08
5. Chakarun CJ, Forrester DM, Gottsegen CJ, Patel DB, White EA, Matcuk GR. Giant Cell Tumor of Bone: Review, Mimics, and New Developments in Treatment. Radiographics [Internet]. Radiological Society of North America; 2013 Jan 1 [cited 2025 May];33(1):197. Available from: https://doi.org/10.1148/rg.331125089
6. Parikh MS, Kale S, Sawant RM, Sane RM, Chaudhari PL. Recurrent Giant Cell Tumor of the Distal End of the Femur. Journal of Orthopaedic Case Reports [Internet]. 2022 Jan 1 [cited 2025 Oct];12(11):42. Available from: https://doi.org/10.13107/jocr.2022.v12.i11.3408
7. Parikh MS, Kale SY, Sawant RM, Sane RM, Chaudhari PL. Case Report. 2022.
8. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. Journal of Bone and Joint Surgery [Internet]. 1987 Jan 1 [cited 2025 Nov];69(1):106. Available from: https://doi.org/ 10.2106/00004623-198769010-00018
9. Khan AQ, Raza QA, Abbas MB, Chowdhry M, Khan MJ. Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination. Malaysian Orthopaedic Journal [Internet]. 2024 Nov 1 [cited 2025 Sep];18(3):42. Available from: https://doi.org/10.5704/moj.2411.006
10. Tsukamoto S, Mavrogenis AF, Masunaga T, Kido A, Honoki K, Tanaka Y, et al. Megaprosthetic reconstruction of the distal femur with a short residual proximal femur following bone tumor resection: a systematic review. Journal of Orthopaedic Surgery and Research [Internet]. 2023 Jan 27 [cited 2025 Nov];18(1):68. Available from: https://doi.org/10.1186/s13018-023-03553-7
11. Bouzid YB, Lamrani MO. Knee megaprosthesis: Analysis of clinical outcomes, complications, and implant survival across complex indications. Journal of Orthopaedic Reports [Internet]. 2025 Mar 26 [cited 2025 Dec];4(2):100632. Available from: https://doi.org/10.1016/j.jorep.2025.100632
12. Zhang H, Wang F, Yang X, Xu M, Qiao R, Li J kai, et al. Establishment and validation of a nomogram model for aseptic loosening after tumor prosthetic replacement around the knee: a retrospective analysis. Journal of Orthopaedic Surgery and Research [Internet]. 2019 Nov 9 [cited 2025 Nov];14(1):352. Available from: https://doi.org/10.1186/s13018-019-1423-3
13. Holm CE, Bardram C, Riecke AF, Horstmann P, Petersen MM. Implant and limb survival after resection of primary bone tumors of the lower extremities and reconstruction with mega-prostheses fifty patients followed for a mean of forteen years. International Orthopaedics. 2018;42(5):1175-1181. doi: 10.1007/s00264-018-38
| How to Cite this Article: Behera BK, Tyagi A, Kaushik S, Maharia A. Long-Term Outcome of Custom-Made Megaprosthetic reconstruction in Recurrent Distal Femoral Giant Cell Tumours: A Case Series. The Odisha Journal of Orthopaedics and Trauma| January 2025; 06;01:14-17.
https://doi.org/10.13107/ojot.2025.v06.i01.66 |
