Outcome of modular megaprosthesis in management of Campanacci Stage III Giant cell tumor around the knee - A Prospective Study

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Abstract

Abstract Purpose : Juxta articular giant cell tumors around the knee constitute 50-60% of the total cases reported. If the disease is detected at an advanced stage, where it has already spread to extraosseous compartment or joint with pathological fractures, reconstruction of the joint after tumor excision poses problems and has poor functional outcome. In this article the functional outcome after resection of juxta-articular giant cell tumors around the knee and its reconstruction with mega prosthetic arthroplasty will be analyzed. Materials and methods: Between January 2017 and March 2021, 14 patients in the age group of 28- 48 years ( mean 42.85 years) with Campanacci Stage three giant cell tumors around the knee were studied . Distal femur was involved in 12 patients and proximal tibia in 2 patients. Patients underwent tumor excision and reconstruction with modular megaprosthesis. They were evaluated post-operatively using the Revised Musculoskeletal Tumor Society Score (MSTS) for lower limb. Results: All the patients were followed up for 12-44 months (mean 29.5 months), the average knee flexion at 6 months being 116.4 degrees. The Mean MSTS at 6 , 12 , 18 and 24 months are 19.45, 23.23, 26.61 and 28.77 respectively. Complications observed were infection and tumor recurrence. Conclusion: In advanced cases where tumor excision leaves large bone segment loss, reconstruction with megaprosthesis can give desirable functional outcome.