The surgical management of the cavity and bone defects in enchondroma cases: A prospective randomized trial

Surg Oncol. 2021 Jun:37:101565. doi: 10.1016/j.suronc.2021.101565. Epub 2021 Apr 5.

Abstract

Background: We compared the curettage/bone grafting and the curettage/bone graft substitutes surgical techniques in their relation to functional outcomes, oncologic outcome (recurrence, malignant transformation), the rate of postsurgical complications, durations of surgery and of postsurgical immobilization for hand-localized cases of solitary and multiple enchondromas.

Methods: The current prospective randomized trial analyzed 200 adult patients (2012-2017) with enchondroma who underwent surgical intervention. The cases were randomly divided into Group 1 (n = 100; F 56, M 44) for surgeries with curettage and autogenous bone grafting, and Group 2 (n = 100; F 55, M 45) for surgeries with curettage and bone graft substitutes. The placebo control Group 3 consisted of cases operated by curettage only (n = 56; F 31, M 25). The follow-up period was set at 30 months.

Results: The duration of surgery was 51 ± 4 min in Group 1 and 27 ± 1 min in Group 2 (p = 0.008). In Group 1, the rate of recurrence was 6% against 1% in Group 2 (p = 0.005). No other statistically significant differences in postsurgical outcomes between three involved groups were noted.

Conclusion: In cases of enchondroma of the hand, postsurgical functional outcomes, the rate of postsurgical complications, the duration of immobilization, and the time to complete recovery are not influenced by the type of chosen grafting material. The implementation of HAp-collagen bone substitutes in granules instead of autogenous bone grafting reduces the duration of surgery. The implementation of autogenous bone grafting may increase the rate of tumor recurrence.

Keywords: Bone grafting; Enchondroma; HAp-collagen bone substitutes; Hand; Surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / pathology
  • Bone Neoplasms / surgery*
  • Bone Substitutes / therapeutic use*
  • Bone Transplantation*
  • Calcium Phosphates / therapeutic use*
  • Chondroma / diagnostic imaging
  • Chondroma / pathology
  • Chondroma / surgery*
  • Collagen / therapeutic use*
  • Curettage*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Prospective Studies
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Bone Substitutes
  • Calcium Phosphates
  • Collagraft
  • Collagen