Video-Assisted Intralesional Curettage for Invasive Nonmalignant Giant Cell Tumors

Giant cell tumor of bone is a locally aggressive benign neoplasm with a strong tendency for local recurrence after surgical treatment. Intralesional excision and curettage is preferred in most cases to maximize tumor removal while preserving the affected joint. The present technical note describes Video-Assisted Intralesional Curettage of Invasive Nonmalignant Giant cell tumors, a technique in which intracavitary 30° arthroscopic visualization is integrated with extended intralesional curettage. After the creation of a cortical window for Campanacci grade 2 lesions or the use of the existing cortical defect for grade 3 lesions, the arthroscope is introduced and rotated through 360° to identify residual pigmented tumor in recesses not visible to the unaided eye. Targeted recurettage, high-speed burring, and monopolar electrocautery on spray mode are then applied under direct video visualization, followed by pulsed saline lavage and reconstruction with polymethyl methacrylate cementation, with the aim of reducing residual microscopic disease at every step.