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GCT lower end femur Cementing 1997 - 2016 Vinod Naneria Girish Yeotikar Arjun Wadhwani Choithram Hospital & Research Centre, Indore, India.

Gct lower end femur

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Page 1: Gct lower end femur

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]