Giant cell tumor of bone (GCTB) is a benign yet locally aggressive neoplasm that commonly arises in the epiphyseal metaphyseal region of long bones, particularly around the knee, where management is challenged by the need to achieve complete tumor excision while preserving joint function in young, active individuals. We describe a 26-year-old female who presented with acute left knee pain and mechanical locking after squatting during exercise. Imaging demonstrated a well-defined 1.7 × 1.7 × 1.7 cm eccentric lesion in the posterior medial tibial plateau with minimal cortical breakthrough and surrounding marrow edema, and CT guided biopsy confirmed the diagnosis of GCTB. She underwent surgery through a posterior Löbbenhofer approach, including meticulous curettage, high speed burring, and phenol application. To shield the articular cartilage from the thermal effects of PMMA cement and avoid long term subchondral stiffness, a protective layer of autologous morselized bone graft was interposed between the cement and the joint surface. Recovery was uneventful, and this single-stage technique provided definitive management with no need for further surgery, ensuring structural support while minimizing recurrence risk. This case highlights the value of combining extended curettage with a graft cement interface to optimize joint preservation in periarticular GCTB and underscores the need for future studies evaluating long term radiological and functional outcomes of such hybrid reconstructions.
Mouawad et al. (Wed,) studied this question.