Efficacy of Hydrogen Peroxide as Adjuvant in Preventing Recurrence of Giant Cell Tumor of Bone

Vol 32 | Issue 3 | Oct-Dec 2017 | page: 17-21 | Rohan Jain, Sandeep Kumar, Anuj Gupta, Arunim Swarup, Rimjhim Shrimal.


Authors: Rohan Jain [1], Sandeep Kumar [1], Anuj Gupta [1], Arunim Swarup [1], Rimjhim Shrimal [1].

[1] Department Of Orthopedics, Subharti, Medical College, Meerut , India.

Address of Correspondence
Dr. Sandeep Kumar,
A GF 90, Ansal town, modipuram, meerut-250110 U.P.
E-mail: drbaliyan051284@gmail.com


Abstract

Aim: To study the effect of hydrogen peroxide (3%) as an adjuvant in preventing local recurrence of giant cell tumor of bone.
Material & Methods: 32 cases of giant cell tumor treated during 2010 -16 were taken in this study initially. 3 cases which could not be followed for minimum of 2 years and 6 cases which were lost to follow up were excluded from study. Also cases involving spine, pelvis and other inaccessible sites were not taken. Thus the present study includes 21 cases of giant cell tumor. The age of patient varies from 18 to 45 yrs. Most patients belong to age group 20-30. Male: Female ratio was 12: 9. In our study, distal femur and distal end radius were the most commonly affected sites (n- 7) each. Lesions around knee(distal femur and proximal tibia) constitutes nearly half of cases. The commonest presenting symptom was swelling associated with pain. All the cases were managed by curettage/en-bloc resection followed by irrigation of cavity with hydrogen peroxide 3%, which was left for 2 minutes .The cavity was thoroughly irrigated with normal saline and filled using bone graft and /or bone graft substitutes or reconstructed using autologous bone.
Results: In total 5 patients showed recurrence, 4 in first year and 1 in second year of follow up. 4(25%) of 16 treated by curettage and G bone/autogenous bone grafting showed recurrence. Out of 5 cases of en-bloc resection with/without reconstruction 1 (20%) recurred.
Conclusion: We conclude that hydrogen peroxide is a cheap, easily available and effective adjuvant for giant cell tumor bone. It reduces recurrence and results are comparable to PMMA, phenol and cryotherapy. The combination of adjuncts (PMMA, burring, H2O2) reduces the likelihood of recurrence compared to curettage alone and therefore should be recommended as the standard treatment.
Keyword: giant cell tumor, hydrogen peroxide, extended curettage


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How to Cite this Article: Jain R, Kumar S, Gupta A, Swarup A, Shrimal R. Efficacy of Hydrogen Peroxide as Adjuvant in Preventing Recurrence of Giant Cell Tumor of Bone. Journal of Bone and Joint Diseases Oct – Dec 2017;32(3):17-21.


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