[Use of cement plugs in the care of giant cell bone tumors]

The classical giant cell tumor represents a problem as the clinical, radiological and histological parameters not always exclude the tendency to local recurrences, rarely also to metastases. Surgical treatment of this tumor is characterized by a relatively high percentage of local recurrences. In the years 1965-1987 patients with 72 giant cell tumors were treated within the Prague Team for Bone Tumors. In 1980 the existing results were revised in 37 patients operated on to that time and the therapeutical scheme was changed by the introduction of new methods mainly the application of bone cement. While in 17 patients we have primarily operated on in the years 1965-1980 recurrence occurred in 36 per cent, in the period 1981-1987 in 32 patients primarily operated on the recurrence amounted to 9.4 per cent, i.e. it occurred in three patients. In these three patients it was the case of excochleation and primary filling by autografts. In 13 cases of the application of bone cement for the filling of the defect after the removal of the tumor there was no recurrence. In the average interval of 1 year since the operation bone cement was substituted by author allografts. In case of an extensive resection of greater part of the joint the application proved right of the massive allografts, fixed by stable osteosynthesis, exclusively in some cases also the application of a special tumorous endoprosthesis in the area of the hip, knee and shoulder.