Construction of clinical score system of giant cell tumors and clinical verification / 中华骨科杂志

ABSTRACT

Objective To establish a clinical score system of giant cell tumors (GCT) according to its morphological features presented on three-dimensional (3D) computed tomographic imaging. Methods Sixteen patients with GCT around knee were included from January 2006 to March 2009. Of the tumors, 9 were located in the distal part of femur, and 7 were in proximal part of tibia. Each patient was exposed to spiral CT preoperatively. Then these primitive CT dates were inputted into digital Orthopedics clinical research platform. With 3D surfaces reconstruction and volume rendering, we reconstructed 3D morphology of GCT. The measurement index included pathological fracture, the degree of involvement of cortical bone, the volume of tumor, the distance between tumor and joint surface and the percentage of involvement areas of articular surface. On account of previous literature and above data, clinical score system of GCT was established. Its feasibility was testified by clinical data. Results A new clinical score system of GCT was established. It was named Hu-Chen Giant Cell Tumor Scale. Full score of the system was 12. In the 16 patients, 5patients whose points was more than 9 elevated by Hu-Chen Giant Cell Tumor Scale preoperatively were treated by wide excision and prosthetic replacement. The postoperative average MSTS score of 5 patients was 27, and there were no recurrence. The 5 patients whose points was 6-8 elevated by Hu-Chen Scale were treated by intralesional excision and structured allograft. The postoperative average MSTS score of the patients was 29, and 1 case underwent recurrence whose points was 8. The 6 patients whose points were less than 6 elevated by Hu-Chen Scale were treated by intralesional excision and morsellized allograft. The postoperative average MSTS score of the patients was 27, and there were no recurrence. Conclusion Hu-Chen Giant Cell Tumor Scale established based on digital techniques includes lots of factors which determined surgical strategy. The grating system is an effectively, reliable method in treatment of GCT.