ABSTRACT
The treatment of malignant bone tumours in children has improved significantly over the past 50 years. Previously, the only curative treatment was amputation, but today the surgical treatment has changed towards limb salvage surgery. However, there is not consensus regarding choice of surgical procedure, and it is mainly based upon the surgeon's previous experience. This review describes four reconstructive methods: rotationplasty, free vascularised fibula graft, bone transport and expandable endoprosthesis. All four methods are suitable surgical options with satisfactory functional outcome, though they vary in complications and revision rates.
Subject(s)
Bone Neoplasms , Orthopedics , Plastic Surgery Procedures , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/surgery , Child , Fibula/diagnostic imaging , Fibula/surgery , Humans , Limb Salvage , Treatment OutcomeABSTRACT
Giant cell tumour of bone (GCTB) is an aggressive bone tumour causing bone destruction. GCTB requires surgical treatment, and severe cases have a high risk of functional morbidity. GCTB consists of receptor activator of nuclear factor kappa-B (RANK)-positive osteoclast-like giant cells. The formation and activity of these cells are mediated by the interaction with RANK ligand (RANKL) released from neoplastic stromal cells. Denosumab is a human monoclonal antibody which inhibits RANKL and impairs the growth of the GCTB. Several studies have described the ability of denosumab to downgrade the extent of surgical treatment and improve the functional outcome.
