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Acta Scientific Orthopaedics (ISSN: 2581-8635)

Case Report Volume 8 Issue 10

Advanced Reconstructive Approach for Recurrent Giant Cell Tumor of the Proximal Tibia: A Case Emphasizing Functional Limb Salvage with Megaprosthesis, Synthetic Extensor Repair, and Flap Coverage

Sameen Raza Kazmi1*, Syed Danish Mehmood2, Osama Anayat3 and Syed M Nalain Abbas4

1Surgery, Temple University, United States
2Orthopaedic Surgery, Islamabad Medical Complex NESCOM, Pakistan
3Orthopaedic Surgery, Islamabad Medical Complex NESCOM, Pakistan
4Orthopaedic Surgery, Islamabad Medical Complex NESCOM, Pakistan

*Corresponding Author: Sameen Raza Kazmi, Surgery, Temple University, United States.

Received: September 10, 2025; Published: October 10, 2025

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Abstract

Background: Giant cell tumor (GCT) of the proximal tibia can be locally aggressive and prone to recurrence after standard curettage. In cases with multiple recurrences, limb preservation becomes increasingly challenging due to compromised soft tissue and extensor mechanism integrity. This case report highlights a multimodal reconstructive strategy following wide resection, showcasing the value of integrating synthetic tendon reconstruction with reliable soft tissue coverage to preserve knee function.

Case Presentation: A 38-year-old male presented with a second recurrence of GCT in the proximal tibia, despite two previous curettage and cementing procedures. Imaging confirmed aggressive local recurrence with cortical and soft tissue involvement. The patient underwent wide resection and implantation of a rotating-hinge megaprosthesis. Given partial patellar tendon excision, a polyethylene terephthalate (PET) mesh tube was used to reconstruct the extensor mechanism. To minimize postoperative complications and ensure durable prosthetic coverage, a medial gastrocnemius flap was used. At six months, the patient exhibited full active knee extension without lag, 95° flexion, and independent ambulation.

Conclusion: This case underscores the importance of a comprehensive limb-salvage approach when managing recurrent GCT. Combining synthetic tendon scaffolding with vascularized flap coverage offers a promising solution for preserving knee extension and functional mobility in patients requiring extensive proximal tibial resection.

Keywords: Giant Cell Tumor; Proximal Tibia; Megaprosthesis; Polyethylene Terephthalate; Extensor Mechanism; Gastrocnemius Flap; Limb Salvage Surgery

References

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Citation

Citation: Sameen Raza Kazmi., et al. “Advanced Reconstructive Approach for Recurrent Giant Cell Tumor of the Proximal Tibia: A Case Emphasizing Functional Limb Salvage with Megaprosthesis, Synthetic Extensor Repair, and Flap Coverage"Acta Scientific Orthopaedics 8.10 (2025): 33-35.

Copyright

Copyright: © 2025 Sameen Raza Kazmi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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