LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR.

S Bhagat; D Pillai; H Sharma; M Naik; P Amin; J Pandit; M.P. Shah

doi:10.1302/0301-620X.90BSUPP_II.0900399a

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LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR.

S Bhagat
D Pillai
H Sharma
M Naik
P Amin
J Pandit
M.P. Shah

LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR.

Bhagat S, Pillai D, Sharma H, et al. LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR.. Orthop Procs. 2008;90-B(SUPP_II):399-399. doi:10.1302/0301-620X.90BSUPP_II.0900399a

Bhagat, S, et al. “LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR..” Orthopaedic Proceedings, vol. 90-B, no. SUPP_II, 2008, pp. 399-399., https://doi.org/10.1302/0301-620X.90BSUPP_II.0900399a

Bhagat, S., Pillai, D., Sharma, H., Naik, M., Amin, P., Pandit, J., & Shah, M. (2008). LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR.. Orthopaedic Proceedings, 90-B(SUPP_II), 399-399. https://doi.org/10.1302/0301-620X.90BSUPP_II.0900399a

Bhagat, S., Pillai, D., Sharma, H., Naik, M., Amin, P., Pandit, J. et al. (2008) “LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR..” Orthopaedic Proceedings, 90-B(SUPP_II), pp. 399-399. Available at: https://doi.org/10.1302/0301-620X.90BSUPP_II.0900399a

Bhagat, S, D Pillai, H Sharma, M Naik, P Amin, J Pandit, and M.P. Shah. “LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR..” Orthopaedic Proceedings 90-B, no. SUPP_II (2008): 399-399. https://doi.org/10.1302/0301-620X.90BSUPP_II.0900399a

Bhagat S, Pillai D, Sharma H, Naik M, Amin P, Pandit J, et al. LONG TERM FUNCTIONAL OUTCOME OF PATIENTS TREATED WITH QUADRICEPS PEDICLED PATELLA IMPLANTATION (MERLE D’AUBIGNE TECHNIQUE) FOR RESECTABLE GIANT CELL TUMOURS WITHOUT INTRAARTICULAR EXTENSION IN DISTAL FEMUR.. Orthop Procs. 2008 Jul 1;90-B(SUPP_II):399-399. https://doi.org/10.1302/0301-620X.90BSUPP_II.0900399a

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Abstract

Objective: To analyse long term outcome of pedicled patellar implantation in treating the defect of the knee joint after the excision of giant cell tumor of distal femur.

Methods: The geometry of patella has lead to its use for condylar reconstruction following resection for giant cell tumour around knee. 15 such patients were treated at our institute and followed up for a mean period of 7.3 years. Average age at presentation was 14.8 years. All patients had plain x-rays, angiography as needed, CT scan and MRI to check integrity of articular cartilage and ACL. Size of lesion was measured on CT. Predominant lateral condyle involvement was found in 6 and medial in 9 patients. The patella was dissociated with a slip of quadriceps attached to its proximal superior-medial pole and rotated to place it horizontally in the zone of resection. Firm osteosynthesis to intact condyle and autogenous bone grafting was carried out.

Results: Grafts consolidated at a mean of 10.8 months. All joints were fairly stable and 70% had movement of 90 degrees without pain. 11 patients had excellent outcome with ability to carry on occupations involving manual labour. There were reoperations for 2 deep infections, 1 recurrence leading to arthrodesis, 1 supracondylar fracture, 2 arthrolysis and 1 valgus osteotomy. 4 patients had arthritic changes and extensor leg at 6 years follow up. No AVN changes or extensor mechanism problems occurred. Using chi square test for log rank analysis significant relationship was found between size of lesion and range of motion (P=0.03) as well as articular cartilage grading and development of arthrosis. The rate of healing was faster than other series reporting free patella grafting.

Conclusion: Patellar implantation is a suitable way to repair the defect of the knee with better immediate functional results subsequently delaying eventual prosthesis surgery.

The abstracts were prepared by Mrs Leslie O’Leary. Correspondence should be addressed to her at British Orthopaedic Association, 35–43 Lincoln’s Inn Fields, London WC2A 3PE or at l.oleary@boa.ac.uk