A Case of Chondroblastoma in the Medial Condyle of the Femur Treated With an Intra-Articular Approach via the Intercondylar Fossa

TL;DR

A new surgical approach for chondroblastoma in the femur's medial condyle is presented, offering effective tumor removal with minimal joint damage.

Contribution

The paper introduces an intra-articular intercondylar approach for chondroblastoma curettage, showing improved outcomes for specific femoral lesions.

Findings

Intercondylar curettage via the posterior cruciate ligament insertion site allowed effective tumor removal with good exposure.

The patient had no recurrence or joint degeneration at 16-month follow-up.

This approach may offer better oncological and functional outcomes than conventional methods for central femoral epiphyseal lesions.

Abstract

Adequate bone curettage is crucial for treating epiphyseal chondroblastomas. However, achieving adequate curettage while minimizing damage to the articular cartilage is challenging. For lesions at the center of the distal femoral epiphysis, curettage using an intercondylar approach may have better oncological and functional outcomes than the conventional extra-articular approach from the wall of the epiphysis. We herein present a case of a 22-year-old male patient with a chondroblastoma of the femoral medial condyle close to the intercondylar fossa. Intercondylar curettage was performed at the site of the insertion of the posterior cruciate ligament (PCL). Maximal knee flexion allowed for good exposure of the lesion, and a direct approach to the tumor led to adequate curettage. Careful suturing of the PCL and postoperative care resulted in sufficient joint stability. The patient showed no signs of local recurrence or osteoarthritic changes at his 16-month follow-up. The intercondylar approach could be a surgical technique worth considering for the treatment of chondroblastoma in the distal femoral epiphysis, particularly for lesions located near the intercondylar fossa.

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