The effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases
Alparslan Yurtbay1, Hüseyin Sina Coşkun2, Hikmet Çinka3, Furkan Erdoğan4, İsmail Büyükceran2, Nevzat Dabak2
1Department of Orthopedics and Traumatology, Samsun University Faculty of Medicine, Samsun, Türkiye
2Department of Orthopedics and Traumatology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
3Department of Orthopedics and Traumatology, Karasu State Hospital, Sakarya, Türkiye
4Department of Orthopedics and Traumatology, Amasya Training and Research Hospital, Amasya, Türkiye
Keywords: Adjuvant, chondroblastoma, cryosurgery, curettage, recurrence.
Objectives: This study aims to investigate the effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases.
Patients and methods: Between January 2004 and December 2020, a total of 30 chondroblastoma cases (19 males, 11 females; median age: 18.6 years; range, 9 to 53 years) who were surgically treated were retrospectively analyzed. The pressurized-spray technique was performed using liquid nitrogen. Data including age, sex, radiological appearance, treatment modality, duration of follow-up, skin problems, and recurrence were recorded. All patients received adjuvant liquid nitrogen cryotherapy after extended intralesional curettage with high-speed burr. The bone cavity was filled with an autologous iliac crest bone graft, allograft, or polymethylmethacrylate (PMMA).
Results: The median follow-up was 54 (range, 19 to 120) months. The lesion was located around the knee in 16 (53.3%), in the shoulder in seven (23.3%), around the hip in five (16.6%), and in the ankle in two (6.6%) cases. The defect was filled with an autologous iliac crest bone graft in 28 (93.3%), an additional allograft in eight (26.7%), and PMMA in two (6.7%) cases. Local recurrence was observed in only two (6.7%) patients during follow-up. Two (6.7%) patients developed physeal growth arrest. Osteoarthritic changes were observed in two (6.7%) patients (one knee and one hip) due to the periarticular location of the tumor. Three (10%) patients had skin complications. None of the cases had a pathological fracture.
Conclusion: A well-performed extended intralesional curettage with high-speed burr is the first and essential step in treating chondroblastoma. Adding adjuvant liquid nitrogen cryotherapy with high-speed burr can improve treatment outcomes and significantly reduce the recurrence rate of this disease.
Citation: Yurtbay A, Coşkun HS, Çinka H, Erdoğan F, Büyükceran İ, Dabak N. The effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases. Jt Dis Relat Surg 2023;34(2):338-345. doi: 10.52312/jdrs.2023.936.
The study protocol was approved by the Ondokuz Mayıs University Clinical Research Ethics Committee (date: 17.07.2020, no: 2020/440). The study was conducted in accordance with the principles of the Declaration of Helsinki.
Material preparation, data collection, and analysis were performed by A.Y., H.S.C., N.D.; Wrote the first draft of the manuscript: A.Y.; H.S.C., H.Ç., and all authors commented on previous versions. All authors contributed to the study's conception and design. All authors read and approved the final manuscript.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
A written informed consent was obtained from each patient and parents and/or legal guardians of pediatric patients.
The data that support the findings of this study are available from the corresponding author upon reasonable request.