Abstract
We report the case of a 26-year-old man who had a pathologic transtrochanteric fracture of the left femur due to a grade II giant cell tumor affecting the neck and the trochanteric area. This patient underwent complete resection of the tumor and arthroplasty using a custom-made cemented total hip prosthesis. The good radiologic and functional results of the surgery have been maintained for over 30 years without local recurrence or lung metastasis. Moreover, new bone formation was observed at the reattachment sites of abductors, iliopsoas tendons and vastus lateralis to the femoral component of the prosthesis although local bone resorption was detected at the upper lateral part of the femoral stem and zone I of the cup side.
Similar content being viewed by others
Abbreviations
- GCT:
-
Giant cell tumor
- THA:
-
Total hip arthroplasty
References
Blackley HR, Wunder JS, Davis AM, White LM, Kandel R, Bell RS (1999) Treatment of giant cell tumor of long bone with curettage and bone grafting. J Bone Joint Surg Am 81:811–820. doi:10.1302/0301-620X.81B1.9001
Deele JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32
Deheshi BM, Jaffer SN, Griffin AM, Ferguson PC, Bell RS, Wunder JS (2007) Joint salvage for pathologic fracture of giant cell tumor of the lower extremity. Clin Orthop Relat Res 459:96–104. doi:10.1097/BLO.0b013e31805d85e4
Goldenberg RR, Cambell CG, Confiblio M (1970) Giant cell tumor of bone. J Bone Joint Surg Am 52:619–664
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fracture: treatment by mold arthroplasty. J Bone Joint Surg Am 51:737–754
Harris WH, McCarthy JC, Oneil DA (1982) Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am 64:1063–1067
Hibino N, Hamada Y, Sairyo K, Yukata K, Sano T, Yasui N (2007) Callus formation during healing of the repaired tendon-bone junction. A rat experimental model. J Bone Joint Surg Br 89:1539–1544. doi:10.1302/0301-620X.89B11.19847
Johnson E, Dahlin DC (1959) Treatment of giant cell tumor of bone. J Bone Joint Surg Am 41:895–904
Kivioja AH, Blomqvist C, Heitaniemi K, Trovik C, Walloe A, Bauer HC et al (2008) Cement is recommended in intralesional surgery of giant cell tumors: a scandinavian sarcoma group study of 294 patients followed for a median time of 5 years. Acta Orthop 79:86–93. doi:10.1080/17453670710014815
Komiya S, Inoue A (1993) Cementation in the treatment of giant cell tumor of bone. Arch Orthop Trauma Surg 112:51–55. doi:10.1007/BF00420253
Kulkarni SS, Dogra AS, Bhosale PB (1996) Total hip arthoplasty for giant cell tumor. J Postgrad Med 42:82–84
McGrath PJ (1972) Giant cell tumor of bone. J Bone Joint Surg Br 54:216–229
McGough RL, Rutledge J, Lewis VO, Lin PP, Yasko AW (2005) Impact severity of local recurrence in giant cell tumor of bone. Clin Orthop Relat Res 438:116–122. doi:10.1097/01.blo.0000180055.76969.08
Morrey BF, Ilstrup D (1989) Size of femoral head and acetabular revision in total hip arthroplasty. J Bone Joint Surg Am 71:50–55
Oda Y, Miura H, Tsuneyoshi M, Iwamoto Y (1998) Giant cell tumor of bone: oncological and functional results of long-term follow-up. Jpn J Clin Oncol 28:323–328. doi:10.1093/jjco/28.5.323
O’donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ (1994) Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg Am 76:1827–1833
Ritter MA, Stringer EA, Littrel DA, Williams JG (1983) Correlation of prosthetic femoral head size and/or design with longevity of total hip arthroplasty. Clin Orthop Relat Res 176:252–257
Sakayama K, Sugawara Y, Kidani T, Miyawaki J, Fujibuchi T, Kamei S et al (2007) Diagnostic and therapeutic problems of giant cell tumor in the proximal femur. Arch Orthop Trauma Surg 127:867–872. doi:10.1007/s00402-007-0419-3
Schmalzried TP, Shepherd EF, Dorey FJ, Jackson WO, dela Rosa M, Fa’vae F et al (2000) Wear is a function of use, not time. Clin Orthop Relat Res 381:36–46. doi:10.1097/00003086-200012000-00005
Sim E, Lang S (1979) Joint salvaging surgery for an extensive giant cell tumor of the proximal femur complicated by a transcervical fracture. Arch Orthop Trauma Surg 116:431–434. doi:10.1007/BF00434008
Tibrewal SB (1986) Treatment of giant cell tumor of the femoral head and neck. J R Soc Med 79:401–404
Trieb K, Bitzan P, Lang S, Dominku M, Kotz R (2001) Recurrence of curetted and bone-grafted giant cell tumor with and without adjuvant phenol therapy. Eur J Surg Oncol 27:200–202. doi:10.1053/ejso.2000.1086
Turcotte RE, Wunder JS, Isler MH, Bell RS, Schachar N, Masri BA et al (2002) Giant cell tumor of long bone: a Canadian sarcoma group study. Clin Orthop Relat Res 397:248–258. doi:10.1097/00003086-200204000-00029
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nakano, S., Enishi, T., Hasan, M.Y. et al. Arthoplasty using a custom-made cemented total hip prosthesis for an extensive giant cell tumor of the proximal femur: report of a patient followed up for over 30 years. Arch Orthop Trauma Surg 129, 1171–1175 (2009). https://doi.org/10.1007/s00402-008-0720-9
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-008-0720-9