Preserving Mobility Versus Ensuring Cure: A Comparative Study of Joint Preservation and Wide Excision for Giant Cell...

Aggressive giant cell tumor can be managed either by joint salvageable surgery or resection surgery. The available literature still needs a consensus on better outcomes among the two. Here, we did a prospective study comparing whether joint preservation surgery or wide excision and reconstruction has a better outcome. A prospective cohort study was conducted from July 2018 to July 2022 on the cases of Campanacci grade II and III giant cell tumor around the knee. Patients were divided into two groups: joint preservation surgery group (A) and wide excision and joint reconstruction group (B). Outcome scores including VAS, KSS function, range of motion, and MSTS score were compared. Out of 34 patients of mean age 28.21 ± 10.78 (17-65) years, 38.23% (n = 13) were males, and 61.76% (n = 21) were females. The final follow-up had a mean follow-up from index surgery of 26.08 ± 13.48 (6-52) months. The recurrence rate after an index surgery was 26.47% (n = 9), with the mean recurrence time following an index surgery being 18.55 ± 10.28 (3-36) months. On comparing post-operative outcome parameters between the two groups, there was a significant difference in KSS function score between the joint preservation group and the wide excision group, with a P-value of 0.0268. Joint preservation surgery should always be the procedure of choice based on the feasibility and salvageability of the joint.