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Use of warm Ringer’s lactate solution in the management of locally advanced giant cell tumor of bone

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Abstract

Background

This study was conducted to discover the effectiveness and safety of using warm Ringer’s lactate solution (RLS) as a local treatment in the management of locally advanced giant cell tumor of bone with marked soft tissue invasion, including nearby neurovascular bundles.

Patients and methods

This was a longitudinal cohort study with an average follow-up period of 4.6 ± 0.3 years, ranging from 4.2 to 5.9 years. There were 21 patients (9 male and 12 female), with the ages of subjects ranging from 12 to 64 years. Eight patients (38 %) were tumor recurrence cases. Pathological fracture was found in 15 patients (71 %). After extended curettage, warm RLS (50 °C) was locally applied for 20 min. Bone stabilization and reconstruction were then performed.

Results

All patients survived the operation. No additional neurovascular injury resulting from the use of warm RLS was found. Patients who had neurological deficit before the operation experienced significant improvement in motor and sensory function during the follow-up period. Complication was found in one patient (5 %). Two patients (9.5 %), had tumor recurrence and 19 patients (90.5 %) were tumor-free with good to acceptable function.

Conclusion

Use of warm Ringer’s lactate solution as an adjunctive local treatment during intra-lesional curettage of giant cell tumor with locally soft tissue extension was found to be safe with relatively low recurrence rate. However, additional studies to identify the optimum thermoablation dose at each part of the body should be undertaken before this technique can be used as a standard treatment.

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Acknowledgments

This study was fully funded by Prasert Prasarttong-Osoth’s Research Grant (G3/2556) which was operated by the Medical Association of Thailand.

Conflict of interest

Saranatra Waikakul, Apichat Asavamongkolkul and Rapin Phimolsarnti serve as the full time staffs of the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. We received a research grant from Prasert Prasarttong-Osoth’s Research Grant via the Medical Association of Thailand. We have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Saranatra Waikakul, Apichat Asavamongkolkul & Rapin Phimolsarnti

  2. 59/2 Soi Chareonjai Ekamai Road, Bangkok, 10110, Thailand

    Saranatra Waikakul

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  1. Saranatra Waikakul
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  2. Apichat Asavamongkolkul
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  3. Rapin Phimolsarnti
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Correspondence to Saranatra Waikakul.

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Waikakul, S., Asavamongkolkul, A. & Phimolsarnti, R. Use of warm Ringer’s lactate solution in the management of locally advanced giant cell tumor of bone. Int J Clin Oncol 21, 177–185 (2016). https://doi.org/10.1007/s10147-015-0856-x

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  • DOI: https://doi.org/10.1007/s10147-015-0856-x

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