Knee Pain And Muscle Atrophy In A Football Player - Page #4
 

Working Diagnosis:
Chondroblastoma

Treatment:
The patient underwent open biopsy of the left femur lesion under general anesthesia. Intraoperative examination confirmed the suspected diagnosis of chondroblastoma.
The procedure was completed with curettage of the remaining tumor and subsequent allografting of the defect with a microparticulate bone graft with adjuvant phenol.Case Photo #7, Case Photo #8

Outcome:
The patient used a knee immobilizer for 4 weeks, and crutches for a total of 6 weeks.
He went to 6 weeks of physical therapy with gradual increasing of weight bearing activities.
At 12 weeks postoperatively he was back to full weight bearing activity, including running and cutting with football, without any discomfort. At 4 months, he was allowed to return to full contact during football.

Author's Comments:
Chondroblastoma is a rare, benign cartilage-forming tumor which typically presents in patients 10-25 years of age, although it can occur at any age. It is nearly twice as common in males as females. The most common locations are the epiphyses or apophyses of long bones, including proximal humerus, distal femur, and proximal tibia.
Treatment includes curettage and bone grafting. Prognosis is fairly good, with recurrence rates around 10-20%. Chondroblastomas do have potential to metastasize to the lungs in 1% of cases.

Editor's Comments:
Following treatment of these tumors, the patient is typically followed for several more years as these tumors are most likely to recur in the first few months or years after treatment. Should the tumor recur, it is often treated using the same curettage and grafting procedures.

References:
Heck, Robert K. Benign/Aggressive Tumors of Bone. Campbell's Operative Orthopedics, 12th ed. Elsevier, Inc, 2013.
Morrell, Nathan. Chondroblastoma. OrthoInfo, June, 2011.
Tis, John E. Benign bone tumors in children and adolescents: An overview. UpToDate, Dec 11, 2014.

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