Gct lower end femur
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GCT lower end femurCementing1997 - 2016
Vinod NaneriaGirish Yeotikar
Arjun WadhwaniChoithram Hospital & Research Centre,
Indore, India.
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Purpose of Presentation
• Long term effect of subchondral cement in development of early cartilage damage & Osteoarthritis.
• Cement fracture in the absence of metal support.• Development of sarcomatous changes due to
Radiation therapy.• Long term effect on functional status of knee
joint.
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Case history
• A 20 yrs old female, GCT lower end femur lt.• Curetting & grafting with Cementing done 1997• Pathological fracture treated conservatively.• Recurrence – 1998• Radiation followed by repeat curettage and
cementing -1998.• Yearly follow up till Jan.2016
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Pathological fracture – 1998Treated conservatively
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Repeat curettage + Cementing + Radiation1999
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Follow up 2000
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Follow up 2006
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Follow up 2009
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MRI for Cartilage damage 2009
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MRI for Cartilage damage 2009
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MRI for Cartilage damage 2009
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Follow up 2013
Piece of cement separation
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Follow up 2015
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Follow up 2015
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Occasional cyst formation
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Case summary
• Follow up from Sept 1997 – January 2016.• Functionally normal – full ROM and squating.• A small piece of cement is lying loose in
posterior – medial soft tissue.• A small fluid collection occurs medially from
the site of cement avulsion occasionally.• Planning to remove the loose piece.
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comments
• We did not find any deterioration in function of knee in spite of repeated squatting and sitting cross legged position.
• Repeated MRI were done to assess early development of Cartilage damage and any sarcomatous changes in the lesion.
• A small piece of cement avulsed from adductor tubercle region and is loose in posterior and medial soft tissue.
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comments
• There is off and on formation of small cyst at the site of avulsion of cement.
• We did not observed any fracture in cement mantle, though three packets of cements were used.
• However there is always a question mark on proper management of secondary OA or Sarcoma if developed, as patient is too young for Maga-prosthesis and there is no bone for fusion of knee.
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DISCLAIMER • Information contained and transmitted by this presentation is based
on personal experience and collection of cases at Choithram Hospital & Research centre, Indore, India.
• It is intended for use only by the students of orthopaedic surgery. • Views and opinion expressed in this presentation are personal. • Depending upon the x-rays and clinical presentations viewers can
make their own opinion. • For any confusion please contact the sole author for clarification.• Every body is allowed to copy or download and use the material best
suited to him. • We not responsible for any controversies arise out of this
presentation. For any correction or suggestion please contact [email protected]