Slide 8 of 23
The lesions were deroofed and thoroughly curetted out. The margins were burred with a high speed burr. It is essential to be able to see all regions and to remove all macroscopic tumour down to pleeding bone. In stage 3 a margin of soft tissue must be removed. Prof. Lindique of Pretoria uses a gastrocmemius flap to cover the resulting defect over grade 3 tibial lesions. I did not find this necessary.
Ablation of micro remnants. Some method of getting rid of micro remnants is necessary if en bloc removal is not resorted to. Open pour cryosurgery was used in 6 cases, Phenol was used in 3. Two advanced cases with extensive soft tissue extension needed megavoltage radiotherapy.
Bone graft was used in 13 patients.
2 had Bone cement inserted as their final method of treatment.
3 has total knee replacements