TY - JOUR
T1 - Fracture risk after intralesional curettage of atypical cartilaginous tumors
AU - Krebbekx, Gitte G. J.
AU - Fris, Felix J.
AU - Schaap, G. R.
AU - Bramer, J. A. M.
AU - Verspoor, F. G. M.
AU - Janssen, Stein J.
N1 - Funding Information: We would like to thank Dilara Savci Heijink for identifying cases in the pathology database of the Amsterdam UMC. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Introduction: The need for curettage of atypical cartilaginous tumors (ACT) is under debate. Curretage results in defects that weaken the bone potentially leading to fractures. The purpose of this study was to retrospectively determine postoperative fracture risk after curettage of chondroid tumors, including patient-specific characteristics that could influence fracture risk. Methods: A total of 297 adult patients who underwent curettage of an ACT followed by phenolisation and augmentation were retrospectively evaluated. Explanatory variables were, sex, age, tumor size, location, augmentation type, and plate fixation. The presence of a postoperative fracture was radiologically diagnosed. Included patients had at least 90 days of follow-up. Results: A total of 183 females (62%) were included and 114 males (38%), with an overall median follow-up of 3.2 years (IQR 1.6–5.2). Mean diameter of the lesions was 4.5 (SD 2.8) cm. Patients received augmentation with allograft bone (n = 259, 87%), PMMA (n = 11, 3.7%), or did not receive augmentation (n = 27, 9.1%). Overall fracture risk was 6%. Male sex (p = 0.021) and lesion size larger than 3.8 cm (p < 0.010) were risk factors for postoperative fracture. Interpretation: Curettage of ACT results in an overall fracture risk of 6%, which is increased for males with larger lesions.
AB - Introduction: The need for curettage of atypical cartilaginous tumors (ACT) is under debate. Curretage results in defects that weaken the bone potentially leading to fractures. The purpose of this study was to retrospectively determine postoperative fracture risk after curettage of chondroid tumors, including patient-specific characteristics that could influence fracture risk. Methods: A total of 297 adult patients who underwent curettage of an ACT followed by phenolisation and augmentation were retrospectively evaluated. Explanatory variables were, sex, age, tumor size, location, augmentation type, and plate fixation. The presence of a postoperative fracture was radiologically diagnosed. Included patients had at least 90 days of follow-up. Results: A total of 183 females (62%) were included and 114 males (38%), with an overall median follow-up of 3.2 years (IQR 1.6–5.2). Mean diameter of the lesions was 4.5 (SD 2.8) cm. Patients received augmentation with allograft bone (n = 259, 87%), PMMA (n = 11, 3.7%), or did not receive augmentation (n = 27, 9.1%). Overall fracture risk was 6%. Male sex (p = 0.021) and lesion size larger than 3.8 cm (p < 0.010) were risk factors for postoperative fracture. Interpretation: Curettage of ACT results in an overall fracture risk of 6%, which is increased for males with larger lesions.
KW - ACT
KW - Fracture risk
KW - Orthopedic oncology
UR - http://www.scopus.com/inward/record.url?scp=85176109693&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s13018-023-04215-4
DO - https://doi.org/10.1186/s13018-023-04215-4
M3 - Article
C2 - 37946306
SN - 1749-799X
VL - 18
JO - Journal of Orthopaedic Surgery and Research
JF - Journal of Orthopaedic Surgery and Research
IS - 1
M1 - 851
ER -