Title: Giant Cell Tumour of Head and Neck of Femur - A Rare Location – Managed with Bipolar-Hemiarthroplasty
Authors: Chennakesava Rao Sajja, Satish Chandra Reddy T, Bhavani Prasad T
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.180
Abstract
Background: Giant cell tumour of bone is a rare but aggressive benign tumour that typically arises adjacent to the sub-chondral bone of major joints in the epiphyseal area of a skeletally mature patient, mainly around the knee, most often involves distal femur, proximal tibia, proximal humerus, and distal radius , Giant cell tumour of the proximal femur(PF) constitutes only 5.5% of all giant cell tumours and femoral head and neck is being rare location. Curettage with or without bone cement results in a higher rate of local recurrence and potential morbidity from further surgery. Although it is better to try and preserve the hip joint, particularly in younger patients, this may not be possible, and alternatives such as exicision and hemiarthroplasty, total hip replacement (THR) or proximal femoral endoprosthetic replacement (EPR) may have to be considered.
Materials & Methodology: 4 young male patients of age between 20-25 years , who have biopsy confirmed Giant cell tumour of femoral head and neck without pathological fracture managed with exision of femoral head replaced with bipolar hemiarthroplasty and followed for 1 ½ years in the Department of Orthopaedics AMC/KGH, vizag.
Results: patients were made partial weight bearing on day 1 and made full weight bearing at day 3 after pain tolerated with post operative recovery being uneventful and no reccurance was reported till now with upto 1 ½ years follow-up.
Conclusion: Exision and hemiarthroplasty is an better alternative to Curettage with or without bone cement (higher rate of local recurrence) and THR/EPR (which are better options in old age). It preserve acetabular articular surface which is particularly helpful in young patients and also less local recurrence.
Keywords: Giant cell tumour, head and neck of femur, bipolar hemiarthroplasty.
