Complications after surgical treatment of chondroblastoma: a single-center retrospective study

Abstract

Introduction:
Chondroblastoma is a rare benign bone tumor typically affecting the epiphysis of long bones in adolescents and young adults. Although intralesional curettage remains the mainstay of treatment, growth plate proximity and joint involvement increase the risk of complications. While oncologic control is well established, data on medium- and long-term functional and orthopedic complications are limited.

Objective:
To describe the medium-term postoperative complications of chondroblastoma, including limb length discrepancy, residual pain, return to sports activities, angular deformities, and joint degeneration.

Methodology:
We conducted a retrospective review of patients treated for chondroblastoma at our orthopedic oncology center between January 2010 and December 2023. Inclusion criteria were patients under 30 years of age with histologically confirmed chondroblastoma, treated surgically with a minimum follow-up of 24 months. Clinical records and radiographic images were evaluated for demographic data, surgical approach, complications, and functional outcomes. The Musculoskeletal Tumor Society (MSTS) score was used for functional assessment. Main complications analyzed included limb length discrepancy (>5 mm), persistent joint pain, joint range of motion limitation, secondary osteoarthritis, angular deformities, and time to return to physical activity.

Results:
A total of 24 patients were included (21 males, 3 females; mean age 22.3 years; median follow-up 82 months). The most common tumor sites were the proximal tibia (32%) and proximal femur (25%). All patients underwent curettage and cavity filling with bone graft. Local recurrence occurred in 2 patients (8.3%). The most frequent complication was residual joint pain, observed in 16.7%, followed by radiographic osteoarthritis in 12.5%. Limb length discrepancy greater than 5 mm was documented in 3 patients (12.5%), and angular deformity in 2 cases (8.3%). Both limb length discrepancies and angular deformities were associated with physeal involvement greater than 33% of the surface area, as documented in preoperative imaging. Notably, 19 patients (79.2%) successfully resumed their previous sports activities within 12 months after surgery. The mean Musculoskeletal Tumor Society (MSTS) score at last follow-up was 28.2 (range 24–30), indicating overall favorable functional outcomes.

Conclusions:
Surgical treatment of chondroblastoma through curettage and bone grafting provides satisfactory oncologic and functional outcomes in the majority of patients. However, medium-term complications such as residual joint pain, radiographic osteoarthritis, and growth-related deformities are not uncommon. Limb length discrepancy and angular deformities were notably associated with preoperative physeal involvement greater than 33%, highlighting the importance of careful imaging evaluation before surgery. Despite these complications, most patients were able to return to their previous level of physical activity within one year. Long-term follow-up is essential to monitor joint integrity and growth disturbances, particularly in cases with physeal involvement.

Key words:
Chondroblastoma, Complications, Osteoarthritis