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Chondroblastoma of the Femur

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Chondroblastoma of the femoral head - Pulmonary metastasis in chondroblastoma - Medial access route to the femoral neck - Autologous graft

Chondroblastoma of the Femur
Figura 1: Radiografia do quadril direito com lesão de rarefação óssea na cabeça femoral direita.
Figure 1: Radiograph of the right hip with bone rarefaction lesion in the right femoral head.
Figura 2: Lesão póstero medial na cabeça femoral direita, em criança em crescimento.
Figure 2: Posteromedial lesion on the right femoral head, in a growing child.
Figura 3: Tomografia do quadril com lesão na cabeça femoral direita, densidade para tecido ósseo.
Figure 3: Tomography of the hip with injury to the right femoral head, density for bone tissue.
Figura 4: Tomografia do quadril com lesão na cabeça femoral direita, densidade para tecidos moles.
Figure 4: Tomography of the hip with injury to the right femoral head, soft tissue density.
In 1992 there was no magnetic resonance imaging and in this location and age group our diagnosis was chondroblastoma and we indicated intalesional curettage surgery (biopsy resection), via medial access, published in the Revista Basileira de Ortopedia (Link:   http://www.rbo .org.br/PDF/32-3/1997_mar_05.pdf  ), figures 5 to 12.
Figura 5: Acesso medial ao colo femoral, como membro el flexão e rotação externa, expondo a região póstero-medial da cabeça femoral, Abertura da cápsula articular em H. Realizamos quatro. Incisões na cartilagem. Uma perpendicular ao colo e três horizontais.
Figure 5: Medial access to the femoral neck, with the member flexing and externally rotating, exposing the posteromedial region of the femoral head, Opening the H-shaped joint capsule. We performed four. Cartilage incisions. One perpendicular to the lap and three horizontal.
Figura 6: Cuidadosamente rebatemos a cartilagem de distal para proximal, sem quebrar no ápice, fixando com ponto de nylon.
Figure 6: We carefully fold the cartilage from distal to proximal, without breaking it at the apex, fixing it with a nylon stitch.
Figura 7: Cureta-se cuidadosamente a cavidade.
Figure 7: Carefully cure the cavity.
Figura 8: Realiza-se adjuvância com eletrotermia e fenol.
Figure 8: Adjunctive therapy is performed with electrothermia and phenol.
Figura 9: Material da curetagem.
Figure 9: Curettage material.
Figura 10: Retirada de enxerto ósseo autólogo da crista ilíaca do mesmo lado.
Figure 10: Removal of autologous bone graft from the iliac crest on the same side.
Figura 11: Flexão com carga, após seis meses da cirurgia.
Figure 11: Flexion with weight, six months after surgery.
Figura 12: Abdução simétrica, após seis meses da cirurgia.
Figure 12: Symmetrical abduction, six months after surgery.
Figura 13: Tomografia pós operatória de dois anos.
Figure 13: Two-year post-operative tomography.
Figura 14: Tomografia de 13/07/1994, após dois anos e seis meses da cirurgia.
Figure 14: Tomography on 07/13/1994, two years and six months after surgery.
Figura 15: Controle tomográfico de 05/08/1999, após sete anos da cirurgia.
Figure 15: Tomographic control on 08/05/1999, seven years after surgery.
Figura 16: Tomografia do quadril em 05/08/1999.
Figure 16: Tomography of the hip on 08/05/1999.
Figura 17: Flexão dos quadrís simétrica, com carga total, em 12/09/2000.
Figure 17: Symmetrical hip flexion, with full load, on 09/12/2000.
Figura 18: Abdução dos quadrís simétrica, com carga total, em 12/09/2000.
Figure 18: Symmetrical hip abduction, with full load, on 09/12/2000.
Figura 19: Flexão dos quadrís simétrica, com carga total, em 12/12/2007, após quinze anos da cirurgia.
Figure 19: Symmetrical hip flexion, with full load, on 12/12/2007, fifteen years after surgery.
Figura 20: Abdução dos quadrís simétrica, com carga total, em 12/12/2007, após quinze anos da cirurgia.
Figure 20: Symmetrical hip abduction, with full load, on 12/12/2007, fifteen years after surgery.
This patient is doing well, with no functional or respiratory complaints despite having multiple pulmonary metastases from chondroblastoma. Some nodules were removed for diagnosis, confirming benign chondroblastoma, without any atypia. The patient has not had any treatment and has multiple calcified pulmonary nodules. This case was published in the Brazilian Journal of Orthopedics, which can be accessed via Link:  http://www.rbo.org.br/PDF/30-11-12/ndz95850.pdf

Authors of the case

Author: Prof. Dr. Pedro Péricles Ribeiro Baptista

 Orthopedic Oncosurgery at the Dr. Arnaldo Vieira de Carvalho Cancer Institute

Office :  Rua General Jardim, 846 – Cj 41 – Cep: 01223-010 Higienópolis São Paulo – SP

Phone: +55 11 3231-4638  Cell:+55  11 99863-5577   Email:  drpprb@gmail.com

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