Long-Term Outcome of Distal Tibia GCT Surgery with Arthrodesis & Tibialization of Fibula скачать в хорошем качестве

Long-Term Outcome of Distal Tibia GCT Surgery with Arthrodesis & Tibialization of Fibula

🦴 Long-Term Outcome of Distal Tibia Giant Cell Tumor Managed with Biological Arthrodesis and Spontaneous Tibialization of Fibula Presenting an interesting 6-year follow-up case illustrating durable oncologic control and functional success after multiple recurrences of a distal tibia Giant Cell Tumor (GCT). 📅 Case Timeline: Jan 2019: Initially treated outside with intralesional curettage and bone cementing. Jun 2019: Referred to our unit with local recurrence; initiated Zoledronic acid therapy to enhance tumor control and sclerosis at margins. Sep 2019: Underwent wide resection of the distal tibia followed by tibiotalar arthrodesis using an ipsilateral fibular graft and plate fixation for reconstruction. 2021: Developed soft tissue local recurrence, which was resected along with implant removal. Aug 2025 (Final Follow-up): The fibula demonstrated marked hypertrophy, achieving a near-complete tibialization, maintaining solid arthrodesis, excellent limb alignment, and pain-free functional ambulation. 🧠 Discussion: This case highlights the biological potential of the fibula to remodel and hypertrophy under axial loading—effectively substituting for the resected tibia. Despite repeated recurrences, the strategy of biological reconstruction following wide resection has provided a durable, infection-free, and functional outcome. 🩺 Key Learning Points: Zoledronic acid can aid in local disease control preoperatively. Fibular-based arthrodesis offers a reliable biological alternative for distal tibial reconstruction. Long-term adaptation and hypertrophy of the fibula underscore the body’s capacity for functional compensation post-oncologic resection. 📈 Follow-up: 6 years disease-free, stable fusion, independent ambulation. #OrthopaedicOncology #GiantCellTumor #DistalTibiaResection #FibularArthrodesis #LimbSalvage #BoneReconstruction #OncologicSurgery #FibularHypertrophy #BiologicalReconstruction #Orthopaedics #TumorSurgery