Denosumab combined with curettage after surgical dislocation of the hip in the treatment of giant cell tumors of bone in the femoral head and neck region: a single-center retrospective study

Overview

This single-center retrospective study examines the clinical application of denosumab as adjuvant therapy in combination with curettage following surgical dislocation of the hip for the treatment of giant cell tumors of bone located in the femoral head and neck region. Giant cell tumors of bone in this anatomical location present significant therapeutic challenges due to the risk of joint destruction and the complexity of preserving hip function. The study evaluates both the efficacy and safety of this combined treatment approach in managing these tumors while maintaining native joint architecture.

Methods and approach

The research employed a retrospective analysis of patients treated at a single institution who underwent surgical dislocation of the hip followed by tumor curettage and adjuvant denosumab therapy for giant cell tumors of bone affecting the femoral head and neck. The treatment protocol involved controlled surgical access through hip dislocation to enable thorough curettage of the tumor while preserving the native joint. Denosumab, a RANKL inhibitor, was administered as adjuvant therapy. The study assessed postoperative outcomes including joint preservation, functional status, tumor recurrence, metastasis, and drug-related complications.

Results

All patients in the study cohort achieved successful preservation of their native hip joints following the combined treatment approach. Functional outcomes were characterized as satisfactory across the patient population. No instances of tumor recurrence or metastatic disease were documented during the follow-up period. The safety profile of denosumab as adjuvant therapy was favorable, with no drug-related complications observed in any patients. These findings indicate that the combination of surgical dislocation, curettage, and denosumab treatment effectively controlled local disease while maintaining joint integrity.

Implications

The findings support the viability of combining denosumab with surgical curettage after hip dislocation as a joint-preserving treatment strategy for giant cell tumors of bone in the challenging femoral head and neck location. The absence of tumor recurrence, metastasis, and drug-related complications suggests this approach offers both oncologic control and acceptable safety parameters. This treatment protocol may provide an alternative to more aggressive surgical interventions such as resection or arthroplasty in selected patients with these tumors. Further investigation through larger multicenter studies with extended follow-up periods would be necessary to establish long-term outcomes and validate these preliminary findings across broader patient populations.