Complications and Salvage Management in Ilizarov Reconstruction After Wide Excision for Distal Femoral Giant Cell Tumour: A Retrospective Series of 10 Cases.

Background Wide excision for Campanacci Grade III giant cell tumours (GCT) of the distal femur results in major segmental defects. Where endoprosthetic reconstruction is limited, Ilizarov distraction osteogenesis provides a biologic limb salvage option, though with frequent mechanical and infectious complications. Objectives The objective of this study was to describe clinical outcomes, complication profiles, management strategies, and salvage interventions in 10 consecutive cases of wide resection followed by Ilizarov reconstruction for distal femoral GCT in young adults. Materials and methods This retrospective review included 10 consecutive eligible patients aged 20-38 years with histologically confirmed Campanacci III distal femur GCT, treated between 2013 and 2020 at a single tertiary referral centre. Inclusion required a segmental defect of at least 8 cm after resection and a minimum of 24 months' follow-up; patients with pre-study recurrence or systemic bone disorders were excluded (2/12 screened). Data collected included defect size, regenerate formation, union time, complications, interventions, and Musculoskeletal Tumour Society (MSTS) scores, using the standard 30-point system. Results The mean defect length was 13.5 cm (range 12-16 cm). Regenerate formation averaged 10.9 cm, with docking-site union achieved in all patients at a mean of 6.2 months (range 5-8 months). Major complications included varus deformity (4/10), pin-tract infection (3/10), docking-site non-union (2/10), fluid collection (3/10), and limb length discrepancy >3 cm (2/10). One non-union required bone grafting and Rail Fixator revision because of patient non-compliance; this was considered a failure of the primary Ilizarov construct but a successful salvage outcome. All patients ultimately achieved union and independent ambulation; the mean MSTS score was 23/30 (range 21-26) at a mean follow-up of 34 months. Conclusion Ilizarov reconstruction after distal femoral GCT excision can achieve limb salvage in selected young adults when alternatives are unavailable. Complications are common but usually manageable with close follow-up, timely intervention, and multidisciplinary care. Larger studies are needed to confirm these findings.