TREATMENT OF LARGE SUBCHONDRAL TUMORS OF THE KNEE WITH CRYOSURGERY AND COMPOSITE RECONSTRUCTION

The radiographic and clinical outcomes of 9 patients with large benign aggressive or low-grade malignant periarticular tumors of the knee wh o were treated with cryosurgery and composite reconstruction (cementat ion, bone graft, and internal fixation) in lieu of primary resection w ere analyzed. The minimum followup was 2 years (range, 24-103 months). There were 6 giant cell tumors and a single case each of chondroblast oma, chondrosarcoma, and fibrosarcoma in the study group. Six lesions involved the distal femur and 3 the proximal tibia. Functional outcome s were graded according to the Enneking Modified System for the Functi onal Evaluation of Tumor and The Knee Rating Scale of The Hospital for Special Surgery. All lesions extended to within 2 mm of the articular surface. Local tumor control was achieved in 8 patients (89%). The si ngle local recurrence was successfully managed with repeat curettage, cryosurgery, cementation, and internal fixation. All 9 patients had ex cellent functional outcomes according to both evaluation scales.