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The Journal of Bone and Joint Surgery 82:1140 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Chondroblastoma of Bone*

Arun J. Ramappa, M.D.{dagger}, Francis Y. I. Lee, M.D.{ddagger}, Peter Tang, M.D.§, Jeffrey R. Carlson, M.D.#, Mark C. Gebhardt, M.D.{dagger} and Henry J. Mankin, M.D.{dagger}

Investigation performed at the Orthopaedic Oncology Service, Massachusetts General Hospital, and Children's Hospital, Harvard Medical School, Boston, Massachusetts
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
{dagger}Orthopaedic Service, Gray 604, Massachusetts General Hospital, Boston, Massachusetts 02114. E-mail address for H. J. Mankin: hmankin{at}partners.org
{ddagger}Department of Orthopaedics, Columbia University School of Medicine, 622 West 168th Street, New York, N.Y. 10032.
§Orthopaedic Service, University of Pittsburgh, Kaufmann Building, 3471 Fifth Avenue, Pittsburgh, Pennsylvania 15213.
#751 J. Clyde Morris Boulevard, Newport News, Virginia 23601.

Background: Chondroblastoma of bone is a rare lesion, and few large series have been reported. The purpose of this paper is to report forty-seven cases treated by one group of surgeons and to identify factors associated with more aggressive tumor behavior.

Methods: Seventy-three patients with chondroblastoma of bone were treated between 1977 and 1998. We were able to obtain historical data, imaging studies, histological findings, and adequate personal or telephone follow-up to determine the outcome for forty-seven patients.

Results: The lesions were distributed widely in the skeleton, but most were in the epiphyses or apophyses of the long bones, especially the proximal part of the tibia (eleven tumors) and the proximal part of the humerus (ten tumors). The principal presenting symptoms were pain and limitation of movement. The treatment consisted of a variety of procedures, but the majority of the patients had intralesional curettage and packing with allograft or autograft bone chips or polymethylmethacrylate. Most of the patients had an excellent functional result, although in three osteoarthritis developed in the adjacent joint. Seven patients (15 percent) had a local recurrence; three of them had a second recurrence and one, a third recurrence. One patient died of widespread metastases, and another who had metastases to multiple sites was alive and disease-free after aggressive treatment of the metastatic lesions.

Conclusions: While the size of the lesion, the age and gender of the patient, the status of the growth plate, and an aneurysmal-bone-cyst component to the tumor had no significant effect on the recurrence rate, lesions around the hip (the proximal part of the femur, the greater trochanter, and the pelvis) accounted for the majority (five) of the seven recurrent tumors and one of the two metastatic lesions.


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