Chondroblastoma: Surgical Therapy

The location and extent of chondroblastoma usually require intralesional resection (excision):

• Procedure: Opening of the tumor → curettage → filling of the bone defect with autologous (patient-derived) cancellous bone (internal, bony network of bone substance).
• Depending on the situation, a so-called bone cement plug can be used temporarily → Advantage: the tumor cells of the marginal zones are killed by the polymerization heat of the cement. Recurrences (recurrence of the disease) at the bone/cement interface can thus be diagnosed more easily. If the patient is one to two years free of recurrence, the bone cement can be removed again and replaced with autologous cancellous bone.
• In addition to bone cement, the following additional adjuvants (effect enhancers) that contribute to a lower recurrence rate have been shown to be effective:
  • Mechanical adjuvants: high-speed milling – Through them, a thermal resection margin expansion is achieved.
  • Physicochemical adjuvants: phenol, alcohol, cryosurgery (kyrotherapy; icing), cauterization (destruction of tissue by a cauterizing iron or cauterizing agent).

To ensure the stability of the bone, after surgery, the bone can be fixed using composite plates (osteosynthesis).

Large tumors may require segmental resection followed by bone implants or tumor endoprostheses.

In the case of chondroblastoma close to the joint surface, resection may require joint replacement.

If a recurrence (recurrence of the disease) occurs, it is resected by means of an en bloc resection, which means that in the same surgical procedure, adjacent tissue or lymph nodes that may have been affected are also removed in addition to the actual finding.If the recurrence affects soft tissue, the widest possible tumor resection is performed.