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An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique.

Tomić S, Lesić A, Bumbasirević M, Sopta J, Rakocević Z, Atkinson HD - J Orthop Surg Res (2010)

Bottom Line: At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site.The patient is able to fully weight bear and stand independently on the operated leg.The case is discussed with reference to the literature.

View Article: PubMed Central - HTML - PubMed

Affiliation: North London Sports Orthopaedics (NLSO), Department of Trauma and Orthopaedics, North Middlesex University Hospital, Sterling Way, London N18 1QX, UK. dusch1@gmail.com.

ABSTRACT
This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature.

No MeSH data available.


Related in: MedlinePlus

Intraoperative radiograph following en-bloc bony resection.
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Figure 7: Intraoperative radiograph following en-bloc bony resection.

Mentions: En-bloc resection of the knee was performed including the proximal 9 cm of tibia, tibial articular surface, the proximal fibula, the patella and quadriceps mechanism, the distal femoral articular surface and 3 cm of diseased femoral epiphysis. An Ilizarov frame was applied with one tibial fixation point 13 cm below the resection level and a second ring below the distal tibial metaphysis; the rings were each fixed with 3 Kirschner wires. The tibia was osteotomized between these 2 rings to allow for distractive proximal bone transport. A single ring was applied to the femur and was connected to the tibial rings using threaded rods (Figure 7). The soft tissues in the front of the knee were repaired in layers. The patient was allowed to weight-bear in his fixator.


An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique.

Tomić S, Lesić A, Bumbasirević M, Sopta J, Rakocević Z, Atkinson HD - J Orthop Surg Res (2010)

Intraoperative radiograph following en-bloc bony resection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2921358&req=5

Figure 7: Intraoperative radiograph following en-bloc bony resection.
Mentions: En-bloc resection of the knee was performed including the proximal 9 cm of tibia, tibial articular surface, the proximal fibula, the patella and quadriceps mechanism, the distal femoral articular surface and 3 cm of diseased femoral epiphysis. An Ilizarov frame was applied with one tibial fixation point 13 cm below the resection level and a second ring below the distal tibial metaphysis; the rings were each fixed with 3 Kirschner wires. The tibia was osteotomized between these 2 rings to allow for distractive proximal bone transport. A single ring was applied to the femur and was connected to the tibial rings using threaded rods (Figure 7). The soft tissues in the front of the knee were repaired in layers. The patient was allowed to weight-bear in his fixator.

Bottom Line: At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site.The patient is able to fully weight bear and stand independently on the operated leg.The case is discussed with reference to the literature.

View Article: PubMed Central - HTML - PubMed

Affiliation: North London Sports Orthopaedics (NLSO), Department of Trauma and Orthopaedics, North Middlesex University Hospital, Sterling Way, London N18 1QX, UK. dusch1@gmail.com.

ABSTRACT
This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature.

No MeSH data available.


Related in: MedlinePlus