الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The most common site of affection of GCT is around the knee joint, which is a crucial joint for everyday activities and hence for leading a normal life, so various surgical methods and technique enhancements were described over the years aiming to optimize the functional and oncological outcome following surgical treatment of the GCT. Surgical treatment can be done either by resection of the affected area followed by joint reconstruction or by curettage of the GCT tissue mass 70,71.
In this study 20 cases of GCT around the knee were treated with extended curettage. In literature, GCT usually affects the patients around the 3rd and 4th decade of life1,5,71. Regarding the age of the patients, all the patients were skeletally mature, the mean age of patients was 33.3±9.71 (ranging from 17 to 53 years old), which is slightly higher than the mean age of patients in Miguel et al., study (mean age of patients was 31 years), but it is lower than the mean age of patients in A.Caubèrea et al., study. (Mean age of the patients was 46 years old)72,73.
Regarding the sex of the patients, there were 11 males (55%) and 9 females (45), which showed slight male predominance. Some studies coincided with this study as in Miguel et al, study where 22 patients were reviewed, of which 16 were males and 6 were females, which is contrary to most literature, that indicates a slight female predominance of GCT as in A.Caubèrea et al, study where 19 patients were reviewed, 8 of which were males and 11 were females72,73.
Regarding the site of the lesion, the distal femur was affected in 9 cases (45%) while proximal tibia was affected in 11 cases (55%),which is contrary to Miguel et al., study where the distal femur was affected in 12 cases (about 54.6%) and proximal tibia was affected in 10 cases (about 45.4%)73.
Most studies agree that ensuring complete removal of the tumor is the most important predictive factor for local recurrence of the GCT 36,73–76. Since adjuvants cannot compensate for bad techniques, better techniques were developed over the years to improve the ability of the curettage to ensure complete eradication of the remnants of GCT. Using a high-speed burr, as we did in all cases of this study, is one of these promising techniques. It is used to extend the curettage and deepens the GCT cavity after the evacuation of the GCT mass. Also, a high-speed burr enables the removal of the remaining bony septa and crista to eliminate any interior cavity space that could be inaccessible during manual curettage and could act as potential hideouts for tumor remnants33,50,77.