Imaging findings and complications after curettage of atypical cartilaginous tumors in long bones: a retrospective single-center cohort study.

Abstract

To assess imaging findings and complications after curettage of atypical cartilaginous tumors (ACTs) in long bones. This retrospective study included patients with central ACTs of long bones treated with curettage, adjuvants, and cementation or bone grafting, who had clinical and imaging follow-up data available for at least 2 years after surgery. All imaging studies (radiographs, CT, MRI) were independently assessed by three radiologists. Clinical information was collected from the medical records. Sixty-eight patients were included (median age [interquartile range, IQR], 53 [45-60] years). Bone graft and cement were used in 53 (77.9%) and 15 (22.1%) patients, respectively. Prophylactic internal fixation was performed in 63 (92.7%) patients. The median (IQR) follow-up duration was 42 (30-64) months. Normal imaging findings were identified at follow-up in 45 patients (66.2%). Our reported complications included peri- (2.9%) and post-operative (8.8%) bone fractures, incomplete bone graft integration (24.5%, out of patients treated with bone grafting), cement loosening (26.7%, out of patients treated with cementation), fixation hardware rupture (1.6%) or loosening (6.3%, out of patients treated with internal fixation) and residual disease (1.5%). Incomplete bone graft integration and cement loosening were associated with tumor location in the humerus (p = 0.023). Inter-reader agreement ranged between moderate and excellent (Fleiss's K = 0.522-1). After curettage of ACTs in long bones, complications are detected on follow-up imaging examinations in one third of patients, mainly including fractures, incomplete bone graft integration and cement loosening.