Graft of allogeneic knee extensor mechanism in treatment of giant cell tumor of the patella
| Autor: | Michal Wolanczyk, Barbara Dragan, Szymon Łukasz Dragan, Szymon Dragan, Piotr Morasiewicz, Łukasz Mucha, Mirosław Kulej, Wiktor Urbański |
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| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Microbiology (medical) 030222 orthopedics medicine.medical_specialty Knee extensors business.industry Knee extensor mechanism grafting lcsh:R lcsh:Medicine GCT Patellar tumor musculoskeletal system Knee extensor mechanism reconstruction Surgery 03 medical and health sciences 0302 clinical medicine Infectious Diseases Giant cell 030220 oncology & carcinogenesis Medicine Patella Giant cell tumor business Allograft of patella |
| Zdroj: | Postępy Higieny i Medycyny Doświadczalnej, Vol 73, Pp 581-587 (2019) |
| ISSN: | 1732-2693 0032-5449 |
| DOI: | 10.5604/01.3001.0013.5602 |
| Popis: | Introduction: Cancer of the patella is a rare condition. Giant cell tumor of the patella is an extremely rare and a difficult to solve therapeutic problem. Depending on the degree of bone destruction, it may cause significant knee joint dysfunction. It is assumed that surgery is the treatment of choice. Material/Methods: This study presents an innovative treatment of a giant cell tumor of the patella in a 40-year-old male with significant dysfunction of the knee extensor mechanism. Complex therapy included neoadjuvant treatment using a human monoclonal antibody IgG2 that binds to RANKL (Denosumab) and follow-up allogeneic grafting of knee extension mechanism. Results: Follow-up CTs showed correct positioning and healing of grafted knee extensor mechanism. Early functional outcome was perfect. Seven weeks after the surgery, reduction of pain, improvement of the contour of the joint, full active extension and flexion of 110° were noticed. Fifteen months after the surgery, the patient presented complete active extension and flexion of the knee joint, actively participated in professional life and CT tests did not reveal features of tumor recurrence. Conclusions: Treatment of isolated giant cell tumor of the patella with destruction of patella and joint dysfunction does not have a clear solution in the available literature. Such a condition may also exclude traditional procedures. In such cases, grafting of the whole extensor mechanism appears to be the appropriate treatment. |
| Databáze: | OpenAIRE |
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