The surgical management of the cavity and bone defects in enchondroma cases: A prospective randomized trial. (June 2021)

• Record Type: Journal Article
• Authors: Nazarova, Nigora Z.; Umarova, Gulrukh Sh; Vaiman, Michael; Asilova, Saodat U.; Abba, Michael; Foonberg, Maya; Shterenshis, Michael
• Is Part Of: Surgical oncology. Volume 37(2021)
• Publication Date: 2021-06
• Subjects: Enchondroma -- Hand -- Surgery -- Bone grafting -- HAp-collagen bone substitutes; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2021.101565
• Languages: English
• ISSNs: 0960-7404

Abstract

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. Highlights: Surgical bone defects can be filled either by bone grafting or by bone substitutes Our randomized trial compared both techniques for enchondroma cases The type of grafting material does not influence postsurgical functional outcomes Duration of surgery is shorter if granulated bone substitutes are used (p = 0.008) The rate of recurrence is higher if autogenous bone grafting is used (p = 0.005)