The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Zoledronic acid for adjuvant treatment of giant cell tumor of bone around the knee

Author : ZHANG Yu- zhe, LIU Ji- jun, ZHENG Jia, et al.     
Working unit : Department of Orthopaedics, People??s Hospital of Henan Province, Zhengzhou University, Zhengzhou 450003, China
Page : 405-409
Key words : zoledronic acid (ZOL), giant cell tumor of bone, knee, auxiliary treatment

    Abstract:

Objective

To explore the effect of zoledronic acid (ZOL) on the joint function, pain, local recurrence, and distant metastasis of the giant cell tumor around the knee after surgical treatment.

Methods

We conducted a retrospective study on 43 patients who had surgical treatment for the giant cell tumor around the knee in our hospital from January 2005 to January 2013. Of them, 29 males and 14 females aged on average of 32 years old ranged from 14 to 43 years. According to whether the patients received postoperative intravenous ZOL, the patients fallen into two groups, including 26 patients in the ZOL group and 17 patients in the non-ZOL group. The visual analogue scale (VAS) and Lysholm score were applied to evaluate the clinical condition, additionally the adverse reaction of ZOL was recorded for assessment of its safety.

Results

There was no statistical significance in VAS and Lysholm score between the two groups before operation (t=0.629, P>0.05; t=-1.596, P=0.118). Although the difference in VAS between the two groups was not statistically significant, the Lysholm score in the ZOL group was  considerably better than that in the non-ZOL group at 1 week after operation, (t=0.855, P=0.397). Compared with those preoperatively,both VAS and Lysholm score in the two groups significantly improved after operation. In addition, the ZOL groups got significantly lower VAS and higher Lysholm score than the non-ZOL group at 3 months after operation (t=-5.248, P<0.001; t=2.729,P=0.005), despite the fact that no statistical differences were noted in the two parameters between them at the latest follow up (t=0.974, P=0.163; t=1.370, P=0.088). Furthermore, the ZOL group proved statistically lower local recurrence rate [3.85% (1/26)versus 17.65% (3/17), P=0.284], and relatively lower distant metastasis rate (pulmonary metastasis) [ 0% (0/26) versus 5.88% (1/17)] than the non-ZOL group at the latest follow up. Some patients presented mild adverse reactions,such as flu-like symptoms, however, no serious adverse reactions, such as liver or kidney function damage, as well as osteonecrosis of the jaw, happened in any of them.

Conclusion

Intravenous ZOL does reduce the local recurrence of the giant cell tumor; improve early pain relief and the knee joint function. We recommend that the ZOL should be used as an auxiliary treatment for bone giant cell tumor of bone around the knee.


summary:
Zoledronic acid for adjuvant treatment of giant cell tumor of bone around the knee   
ZHANG Yu- zhe, LIU Ji- jun, ZHENG Jia, et al.
Orthop J Chin,2018,26(5):   405-409