The Need of Filling of Bone Defects After Curettage of Benign Bone Tumors

Ismail Tawfeek Abdelaziz¹, Ahmed El-Badawy Mahmoud Shahin¹, Ahmed Mohammed Ahmed Fawzy El-Beheiry¹ and Bola Adel Alfy Hakim²*

¹MD of Orthopedic Surgery, Horus Specialized Hospital, Luxor, Egypt
²MSc of Orthopedic Surgery, Horus Specialized Hospital, Luxor, Egypt

*Corresponding Author: Bola Adel Alfy Hakim, MSc of Orthopedic Surgery, Horus Specialized Hospital, Luxor, Egypt.

Received: May 20, 2022; Published: July 15, 2022

Background: Benign bone tumors regularly weaken bones and predispose patients to pathological fractures. Benign lytic bone lesions such as Simple Bone Cyst, Non-Ossifying Fibroma, Fibrous Dysplasia, etc. most often affect younger individuals.

Treatment includes observation, injection of bone marrow or demineralized bone matrix, curettage blended with bone or synthetic grafting, decompression with intramedullary nailing or cannulated screw, or a mixture of these approaches.

This study aims to clinical and radiological evaluation of benign bone tumors after curettage with or without filling of bone defects.

Patients and Methods: This is a retrospective study diagnosed as benign bone tumors who underwent curettage (with or without grafting or filling) during the surgical treatment, operated between Jan 2017 and Feb 2021. Lesions’ size (length, width, and depth) was measured on plain radiographs using the image j program. When applicable, the degrees of filling of the resultant cavity were classified into four categories according to Modified Neer's classification. Functional evaluation using the musculoskeletal tumor society (MSTS) score was also reviewed

Results: 41 patients were included in this study, 19 male (46.3%) and 22 female (53.7%) ranged from 3 to 53 years old with a mean age of 22.83 ± 13 years.

Extended curettage was done in 32 cases (78%). Hydrogen peroxide was used in 34 cases (82.9%). High-speed burr was performed in 34 cases (82.9%). Filling materials were mainly bone cement in 13 cases (31.7%) and Autograft in 7 cases (17.1%), while 21 cases (51.2%) were without any filling material.

Cystic lesions were mainly centric, while NOFs and GCTs were mainly eccentric.

Most benign tumors expressed cortical involvement, while UBCs didn't. The lesion size varies according to its type.

51% of cases were not filled with any type of fillers, 32% were filled with cement, and 17% with autograft. This depends on many variables such as Skeletal maturity, Lesion centricity, Cortical breakdown, curettage, and age.

Conclusion: Filling defects resulting from curettage of benign bone tumors by autograft showed the best results. Better results are obtained while using plate osteosynthesis. Level of evidence: Level III, retrospective.

Keywords:Enneking; Benign Bone Tumors; Filler; Surgical Interventions; Extended Curettage; Giant Cell Tumor; Simple Bone Cyst; Non-Ossifying Fibroma; Osteolytic; Bone Defects

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Citation

Citation: Bola Adel Alfy Hakim., et al. “The Need of Filling of Bone Defects After Curettage of Benign Bone Tumors". Acta Scientific Orthopaedics 5.8 (2022): 84-97.

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Copyright: © 2022 Bola Adel Alfy Hakim., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.