Background: Giant cell tumour of bone is a rare but aggressive benign tumour that typically arises adjacent to the sub-chondral bone of major joints in the epiphyseal area of a skeletally mature patient, mainly around the knee, most often involves distal femur, proximal tibia, proximal humerus, and distal radius , Giant cell tumour of the proximal femur(PF) constitutes only 5.5% of all giant cell tumours and femoral head and neck is being rare location. Curettage with or without bone cement results in a higher rate of local recurrence and potential morbidity from further surgery. Although it is better to try and preserve the hip joint, particularly in younger patients, this may not be possible, and alternatives such as exicision and hemiarthroplasty, total hip replacement (THR) or proximal femoral endoprosthetic replacement (EPR) may have to be considered.

Materials & Methodology: 4 young male patients of age between 20-25 years , who have biopsy confirmed Giant cell tumour of femoral head and neck without pathological fracture managed with exision of  femoral head replaced with bipolar hemiarthroplasty and  followed for 1 ½ years in  the Department of Orthopaedics AMC/KGH, vizag.

Results:  patients were made partial weight bearing on day 1 and made full weight bearing at day 3 after pain tolerated with post operative recovery being uneventful and no reccurance was reported till now with upto 1 ½ years follow-up.

Conclusion: Exision and hemiarthroplasty is an better alternative to Curettage with or without bone cement (higher rate of local recurrence) and THR/EPR (which are better options in old age). It preserve acetabular articular surface which is particularly helpful in young patients and also less local recurrence.

Keywords: Giant cell tumour, head and neck of femur, bipolar hemiarthroplasty.

1. Unni KK, Inwards CY, eds. Dahlin’s bone tumours. Sixth ed. Philadelphia: Lippincott Williams & Wilkins, 2010.        
2. Gaston CL, Bhumbra R, Watanuki M, et al. Does the addition of cement improve the rate of local recurrence after curettage of giant cell tumours in bone? J Bone Joint Surg [Br] 2011;93-B:1665–1669.
3. Filho RJG, Korukian M, Ishirara HI, Miceno Filho NM,Figueiredo MTB, Seixas MT. É a curetagem um métodoeficiente no tratamento dos tumores ósseos? Rev Bras Ortop.1993;28 (11/12):813–6.5
4. Omar Kirmani, Nasir Muzaffar*, Mohammad Ehsan, Shamim Ahmad- Giant Cell Tumour of the Femoral Neck: A Rare Site Managed by Curettage and Bone Grafting Only, Global Journal of Surgery, 2013, Vol. 1, No. 3, 22-24.
5. Menendez LR, Ahlmann ER, Kermani C, Gotha H.Endoprosthetic reconstruction for neoplasms of the proximalfemur. Clin Orthop Relat Res. 2006;450:46–51.
6. Croci AT, Camargo OP, Baptista AM, Caiero MT. The use of amodular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation andanalysis of 37 cases. Rev Hosp Clin Fac Med São Paulo. 2000;55(5):169–76.
7. Donati D, Giacomini S, Gozzi E, Mercuri M. Proximal femurreconstruction by an allograft prosthesis composite. ClinOrthop Relat Res. 2002;(394):192–200.
8. Kulkarni SS, Dogra AS, Bhosale PB. Total hip arthroplasty forgiant cell tumour. J Postgrad Med. 1996;42(3):82–4.
9. O'Donell RKJ, Springfield DS, Motwani HK et al. Recurrence of giant-cell tumors of long bones after curettage and packing with cement. J Bone Joint Surg [Am]1994;76-A: 1827-33.
10. Szendroi, M. Giant cell tumour of bone. J Bone Joint Surg Br 86-B (1):5-12, January 2004.

Chennakesava Rao Sajja

Junior Resident, Department of Orthopaedics, King George Hospital, Andhra Medical College, Visakhapatnam, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.