Curettage with adjuvants and filling
Curettage empties a bone lesion from the inside, preserving the bone and the joint. It is used for benign or intermediate bone tumors, such as giant cell tumor.
How is it done?
A window is opened in the bone and the lesion is removed with curettes, emptying the cavity.
The cavity walls are treated (for example with burring, chemical or thermal agents) to reduce the risk of recurrence.
The defect is filled with bone cement or graft, restoring support to the bone.
When is it indicated?
- Giant cell tumor of bone.
- Chondroblastoma and other benign cartilaginous lesions.
- Cysts and benign lesions that are symptomatic or at risk of fracture.
- Atypical cartilaginous tumor of the long and short bones of the limbs, in selected cases.
- Selected intermediate-behavior lesions.
Why empty rather than resect
Curettage treats the lesion from inside the bone, without removing the whole segment. In benign and intermediate tumors this preserves the bone and, most importantly, the neighboring joint, which would otherwise have to be replaced.
It is a delicate balance: emptying the cavity and treating its walls thoroughly reduces recurrence, but as much healthy bone as possible must be preserved so the area stays strong after filling.
Recovery and follow-up
Recovery is usually faster than after a major reconstruction, and weight-bearing is often protected for a few weeks while the filling and bone settle. The goal is to preserve the joint with a good functional result.
Some lesions —such as giant cell tumor— carry a risk of recurrence, so imaging follow-up is maintained over the following years to detect it early.
In giant cell tumor, denosumab has a limited role: it is used mainly for lesions that cannot be removed or are hard to reach, and to shrink the tumor before an en-bloc resection. It is not given routinely before curettage, because in that sequence it has been associated with more local recurrence; its use is decided case by case with the treating team.
Risks and considerations
- Local recurrence, more frequent in giant cell tumor, which may require another curettage or a resection.
- Fracture of the weakened bone, during recovery or at the site of the bone window.
- Damage to the neighboring cartilage when the lesion reaches the joint surface.
- Infection of the wound or of the surgical site.
- Need for a larger operation if the definitive diagnosis turns out to be different from the one expected.
Shared decision-making
The decision to operate is made together: we discuss the diagnosis, the goals of treatment, the expected benefits, the risks and the alternatives. Surgery does not guarantee an outcome; it aims to control the tumor while preserving as much function as possible.
This information is educational and does not replace a medical evaluation. Every case requires an individualized assessment and treatment, and no surgery guarantees an outcome.
Questions about your case?
Book an evaluation at RedSalud Vitacura or the Instituto Oncológico FALP.
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