{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:31:21Z","timestamp":1785447081005,"version":"3.56.0"},"reference-count":34,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Curettage represents a reliable therapeutic option for large-sized benign and locally aggressive bone tumors. In cases of impending fractures, internal fixation with plates and screws can be necessary to stabilize the treated bone after curettage. Metal plates have been the only fixation devices available on the market for decades, but Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) now represents an alternative in orthopedic oncology. Methods: We reviewed our patients with benign or locally aggressive bone tumors treated with curettage and fixation with CFR-PEEK plates. Plate length and curettage technique were chosen considering the characteristics of each lesion. We recorded the size and location of the lesions, adjuvant treatments and fillers used after curettage, complications, and local recurrences. Postoperative functionality was assessed using the MSTS score. Results: Forty cases were included in our study. The tumors were located in the distal femur (19 cases), femur shaft (1), humerus (17), or proximal tibia (3). Local adjuvants were used in 20 cases. Cavities were filled with bone allografts in 30 cases and cement in 10 cases. Only four cases suffered postoperative complications, and two developed local recurrences. The mean postoperative follow-up was 29.2 months. The mean postoperative upper and lower limb MSTS was 28.0 and 26.7, respectively. Conclusions: After an accurate curettage and an adequate filling of the resulting bone gap, CFR-PEEK plates can provide good mechanical resistance, and their radio-transparency can ease the early diagnosis of local recurrences. CFR-PEEK plates should be considered in selected cases, in a personalized surgical approach.<\/jats:p>","DOI":"10.3390\/jcm14072371","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T02:50:16Z","timestamp":1743389416000},"page":"2371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fixation with Carbon Fiber Plates After Curettage in Benign and Locally Aggressive Bone Tumors: Clinical and Radiographic Outcomes"],"prefix":"10.3390","volume":"14","author":[{"given":"Edoardo","family":"Ipponi","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bechini","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Bettarini","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9353-4320","authenticated-orcid":false,"given":"Martina","family":"Cordoni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizia","family":"Gentili","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"D\u2019Arienzo","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7560-7104","authenticated-orcid":false,"given":"Paolo Domenico","family":"Parchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8268-6987","authenticated-orcid":false,"given":"Lorenzo","family":"Andreani","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"key":"ref_1","first-page":"92","article-title":"Epidemiology and classification of bone tumors","volume":"9","author":"Franchi","year":"2012","journal-title":"Clin. Cases Miner. Bone Metab."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"De Salvo, S., Pavone, V., Coco, S., Dell\u2019Agli, E., Blatti, C., and Testa, G. (2022). Benign Bone Tumors: An Overview of What We Know Today. J. Clin. Med., 11.","DOI":"10.3390\/jcm11030699"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20503121221094199","DOI":"10.1177\/20503121221094199","article-title":"Treatment of locally aggressive benign bone tumors by means of extended intralesional curettage without chemical adjuvants","volume":"10","author":"Sofulu","year":"2022","journal-title":"SAGE Open Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Omlor, G.W., Lohnherr, V., Lange, J., Gantz, S., Mechtersheimer, G., Merle, C., Raiss, P., Fellenberg, J., and Lehner, B. (2019). Outcome of conservative and surgical treatment of enchondromas and atypical cartilaginous tumors of the long bones: Retrospective analysis of 228 patients. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2502-7"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"iv79","DOI":"10.1093\/annonc\/mdy310","article-title":"Bone sarcomas: ESMO-PaedCan-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"29","author":"Casali","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Tsukamoto, S., Mavrogenis, A.F., Akahane, M., Honoki, K., Kido, A., Tanaka, Y., Donati, D.M., and Errani, C. (2022). Risk factors of fracture following curettage for bone giant cell tumors of the extremities. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05447-x"},{"key":"ref_7","first-page":"206","article-title":"Curettage of giant cell tumor of bone. The effect of surgical technique and adjuvants on local recurrence rate","volume":"75","author":"Capanna","year":"1990","journal-title":"Chir. Organi Mov."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"D\u2019arienzo, A., Scognamiglio, B., Campo, F.R., Cosseddu, F., Ruinato, D.A., Ipponi, E., Carbone, M., Condino, S., Ferrari, V., and Andreani, L. (2023). Preliminary Results of Preoperative Planning Using 3D Printing and Augmented Reality in Cryotherapy Treatment of Giant Cell Tumor of Bone-CRIO2AR Project. Healthcare, 11.","DOI":"10.3390\/healthcare11192629"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Andreani, L., Ipponi, E., Serrano, E., De Franco, S., Cordoni, M., Bechini, E., D\u2019arienzo, A., and Parchi, P.D. (2023). Aneurysmal Bone Cyst of the Pelvis in Children and Adolescents: Effectiveness of Surgical Treatment with Curettage, Cryotherapy and Bone Grafting. Healthcare, 11.","DOI":"10.3390\/healthcare11192658"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102966","DOI":"10.1016\/j.otsr.2021.102966","article-title":"Treatment alternatives and clinical outcomes of bone filling after benign tumour curettage. A systematic review","volume":"108","author":"Gava","year":"2022","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1186\/s13018-023-03895-2","article-title":"Microwave-induced hyperthermia in situ in the treatment of tumors of proximal humerus: Long-term results with functionary sparing surgery","volume":"18","author":"Pang","year":"2023","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/ortho.IJOrtho_209_17","article-title":"Benign Aggressive Lesions of Femoral Head and Neck: Is Salvage Possible?","volume":"52","author":"Panchwagh","year":"2018","journal-title":"Indian J. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1186\/s13018-018-0982-z","article-title":"Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft","volume":"13","author":"Zekry","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s11420-009-9125-8","article-title":"Cryosurgery and impaction subchondral bone graft for the treatment of giant cell tumor around the knee","volume":"5","author":"Abdelrahman","year":"2009","journal-title":"HSS J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/s12957-018-1437-z","article-title":"Enchondromas and atypical cartilaginous tumors at the proximal humerus treated with intralesional resection and bone cement filling with or without osteosynthesis: Retrospective analysis of 42 cases with 6 years mean follow-up","volume":"16","author":"Omlor","year":"2018","journal-title":"World J. Surg. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Boffano, M., Ratto, N., Conti, A., Pellegrino, P., Rossi, L., Perale, G., and Piana, R. (2020). A Preliminary Study on the Mechanical Reliability and Regeneration Capability of Artificial Bone Grafts in Oncologic Cases, With and Without Osteosynthesis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051388"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s10195-016-0418-7","article-title":"Indications for prophylactic osteosynthesis associated with curettage in benign and low-grade malignant primitive bone tumors of the distal femur in adult patients: A case series","volume":"17","author":"Perisano","year":"2016","journal-title":"J. Orthop. Traumatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2691","DOI":"10.1007\/s00264-018-3922-y","article-title":"Surgical strategy for benign lesions in proximal femur: Internal fixation or endoprosthetic replacement","volume":"42","author":"Liu","year":"2018","journal-title":"Int. Orthop."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1111\/os.14075","article-title":"3D-printed Multifunctional Guide Plate for Fenestration and Screws Drill in Proximal Femoral Benign Tumor","volume":"16","author":"Zhang","year":"2024","journal-title":"Orthop. Surg."},{"key":"ref_20","first-page":"210","article-title":"Which one of the benign tumors and tumor-like lesions located in long bones needs prophylactic fixation during surgery?","volume":"32","author":"Yapar","year":"2021","journal-title":"Jt. Dis. Relat. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3000605211025403","DOI":"10.1177\/03000605211025403","article-title":"Evaluation of bone grafting for treatment of low-grade chondrosarcoma of long bones","volume":"49","author":"Zhang","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s12981-021-00406-3","article-title":"Reconstruction and repair, using mini-plate and bone graft for persons living with HIV with giant cell tumor of long bone: Retrospective analysis of a single-center experience","volume":"18","author":"Xu","year":"2021","journal-title":"AIDS Res. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e945157","DOI":"10.12659\/MSM.945157","article-title":"Comparative Analysis of Extended Curettage with Plate Fixation and Extended Curettage with Intramedullary Nail Fixation for Campanacci Grade II and International Society of Limb Salvage Zone H2 Giant Cell Tumors of the Proximal Femur: A Retrospective Study","volume":"30","author":"Song","year":"2024","journal-title":"Med. Sci. Monit."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s10195-023-00724-4","article-title":"Carbon-fibre plates for traumatic and (impending) pathological fracture fixation: Where do we stand? A systematic review","volume":"24","author":"Rijs","year":"2023","journal-title":"J. Orthop. Traumatol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Carbon-Fiber International Collaboration Initiative Research Group (2022). Complications of patients with bone tumors treated with carbon-fiber plates: An international multicenter study. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-23519-9"},{"key":"ref_26","first-page":"e134","article-title":"Outcomes of Long Bones Treated with Carbon-Fiber Nails for Oncologic Indications: International Multi-institutional Study","volume":"32","author":"Rijs","year":"2024","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/00003086-198912000-00027","article-title":"Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures","volume":"249","author":"Mirels","year":"1989","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/17453670902804505","article-title":"Bone defects following curettage do not necessarily need augmentation","volume":"80","author":"Hirn","year":"2009","journal-title":"Acta Orthop."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4103\/0019-5413.111507","article-title":"Curettage of benign bone tumors and tumor like lesions: A retrospective analysis","volume":"47","author":"Kundu","year":"2013","journal-title":"Indian J. Orthop."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Borrelli, S., Putame, G., Audenino, A.L., Bignardi, C., Ferro, A., Marone, S., and Terzini, M. (2023). Cross-link augmentation enhances CFR-PEEK short fixation in lumbar metastasis stabilization. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1114711"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S313","DOI":"10.1016\/j.otsr.2013.07.006","article-title":"French Sarcoma and Bone Tumor Study Groups GSF-GETO. Local recurrence after curettage treatment of giant cell tumors in peripheral bones: Retrospective study by the GSF-GETO (French Sarcoma and Bone Tumor Study Groups)","volume":"99","author":"Gouin","year":"2013","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1007\/s00256-024-04624-4","article-title":"Managing hardware-related metal artifacts in MRI: Current and evolving techniques","volume":"53","author":"Feuerriegel","year":"2024","journal-title":"Skelet. Radiol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Yeung, C.M., Bhashyam, A.R., Patel, S.S., Ortiz-Cruz, E., and Lozano-Calder\u00f3n, S.A. (2022). Carbon Fiber Implants in Orthopaedic Oncology. J. Clin. Med., 11.","DOI":"10.3390\/jcm11174959"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jor.2023.09.011","article-title":"A PEEK into carbon fiber: A practical guide for high performance composite polymeric implants for orthopaedic oncology","volume":"45","author":"Clunk","year":"2023","journal-title":"J. Orthop."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/7\/2371\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:05:38Z","timestamp":1760029538000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/7\/2371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,29]]},"references-count":34,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jcm14072371"],"URL":"https:\/\/doi.org\/10.3390\/jcm14072371","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,29]]}}}