Publication:

Patellar giant cell tumour treated with extended curettage, bone grafting and extensor mechanism augmentation: a case report

Giant cell tumour of bone (GCTB) rarely involves the patella and can present with persistent anterior knee pain and progressive functional limitation. In patellar lesions, joint-preserving tumour surgery must balance local control with preservation of the extensor mechanism. A 21-year-old man presented with six months of left anterior knee pain, present at rest and worsened with activity. Imaging demonstrated an expansile lytic patellar lesion. After an unavoidable delay of approximately three months in early 2020, the lesion progressed clinically with increasing functional limitation. He underwent extended curettage of the patellar lesion and reconstruction with autologous cancellous iliac crest bone graft. To protect the extensor mechanism following tumour excision and reconstruction, patellar tendon augmentation was performed using an ipsilateral hamstring autograft and suture tape reinforcement secured to the tibia through a transverse osseous tunnel. Histopathology confirmed a GCTB. The patient achieved excellent recovery within one year and maintained near-normal function at five-year follow-up without evidence of recurrence. In selected patellar giant cell tumours where extensor mechanism integrity is threatened after joint-preserving surgery, hamstring autograft augmentation with suture tape reinforcement may provide durable functional restoration.