Summary
Two patients with giant cell tumour of the lateral tibial condyle underwent en bloc resection and reconstruction by pedicled vascularized fibular graft. Both had good functional results and rapid solid bony union. This procedure preserved the lateral stabilizing structures of the knee, allowed relatively early mobilization and provided some cartilagionous surface for articulation with the lateral femoral condyle. The procedure was technically simple compared with homograft reconstruction, prosthetic replacement or free vascularized bone grafts, and could be performed in less sophisticated centres. The operation also provided additional bone stock for subsequent fusion if necessary.
Résumé
Les auteurs rapportent le cas de deux patients présentant une tumeur à cellules géantes du condyle externe du tibia qui ont subi une résection et une reconstruction par une greffe de péroné vascularisée. Les deux malades ont eu un bon résultat fonctionnel et une fusion osseuse rapide et solide. Ce procédé préserve les sructures externes stabilisatrices du genou et permet une mobilisation relativement précoce. De plus, il apporte une surface cartilagineuse au condyle externe du fémur. Le procédé est techniquement simple, comparativement à la reconstruction par homogreffe, au remplacement par prothèse ou par greffes osseuses libres vascularisées. Cette technique peut donc être facilement exécutée dans des centres hospitaliers moins sophistiqués. Cette opération apporte également une quantité d'os supplémentaire pour le cas où une arthrodèse s'avérerait nécessaire.
Similar content being viewed by others
References
Boytchev B (1970) Operative treatment of malignant para-articular bone tumour. In: Chapchal G (ed) Operative treatment of bone tumours. Thieme Stuttgart pp 41–48
Burrows HJ, Wilson JN, Scales JT (1975) Excision of tumours of humerus and femur with restoration by internal prosthesis. J Bone Joint Surg [Br] 57: 148–159
Chase SW (1955) The fate of autogenous and homogenous bone grafts — A historical review. J Bone Joint Surg [Am] 37: 809–841
Enneking WF, Shirley PD (1977) Resection — arthrodesis for malignant and potentially malignant lesion about the knee using an intramedullary rod and local bone graft. J Bone Joint Surg [Am] 59: 223–236
Freehafer AA, Goldman S, Chapman K (1973) Stubbin's arthroplasty for fractures of tibial condyles. Clin Orthorp 90: 140–145
Goldenberg RR, Cambell CJ, Bonfiglio M (1970) Giant cell tumour of bone. J Bone Joint Surg [Am] 52: 619–664
Johnston JO (1980) Local resection in primary malignant bone tumours. Clin Orthop 153: 73–80
Larsson SE, Lorentzon R, Boquint L (1975) Giant cell tumour of bone. J Bone Joint Surg [Am] 57: 167–173
Lee HG (1957) Osteoplastic resection in severe fracture of tibial condyle — utilization of the anterior superior iliac spine. Am J Surg 94: 940–944
Parrish FF (1966) Treatment of bone tumour by total excision and replacement and massive autogenous and homogenous bone grafts. J Bone Joint Surg [Am] 48: 968–990
Peimer CA, Schilles AL, Mankin HJ, Smith RJ (1980) Multicentric giant cell tumour of bone. J Bone Joint Surg [Am] 62: 652–659
Persson BM, Ekelund L, Lovdahl R, Gunterberg B (1984) Favourable result of acrylic cementation for giant cell tumours. Acta Orthop Scand 55: 209–214
Smith WS, Simon MA (1975) Segmental resection for chondrosarcoma. J Bone Joint Surg [Am] 57: 1097–1103
Thompson VP, Stegall CT (1956) Chondrosarcoma of proximal part of femur: treatment by resection and bone replacement. J Bone Joint Surg [Am] 38: 357–367
Verbeek O, Kingma MJ (1973) Reconstructive surgery of long bone with autogenous and homogenous bone graft. HE Stenfert Kroese NV/Leiden
Volkow M (1970) Homotransplantation of bone in the operative treatment of bone tumours in children. In: Chapchal G (ed) operative treatment of bone tumours. Thime Stuttgart, pp 29–34
Weiland AJ, Moore JR (1983) Vascularized bone autografts. Clin Orthop, 174: 87–95
Wilson PD, Lance EM (1965) Surgical reconstruction of skeleton following segmental resection for bone tumours. J Bone Joint Surg [Am] 47: 1629–1656
Wilson WJ, Jacobs JE (1952) Patella graft for severely depressed comminuted fractures of the lateral tibial condyle. J Bone Joint Surg [Am] 34: 436–442
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chow, S.P., Chan, K.C., Tang, S.C. et al. Reconstruction of the lateral tibial condyle by a pedicled vascularized fibular graft after en bloc resection of giant cell tumour. International Orthopaedics 10, 239–243 (1986). https://doi.org/10.1007/BF00454403
Issue Date:
DOI: https://doi.org/10.1007/BF00454403