SVOA Orthopaedics

Alexander Western^1*, Derrick Lousaing^1*, Shane Lee Loy^1*

¹Fracture and Orthopaedic Clinic Limited, Port of Spain, Trinidad and Tobago.

*Corresponding Authors: Dr. Derrick Lousaing, Dr. Derrick Lousaing, Dr. Shane Lee Loy, Fracture and Orthopaedic Clinic Limited, Port of Spain, Trinidad and Tobago and Dr. Shane Lee Loy, Fracture and Orthopaedic Clinic Limited, Port of Spain, Trinidad and Tobago.

https://doi.org/10.58624/SVOAOR.2026.06.029

Received: August 26, 2026

Published: October 05, 2026

Citation: Western A, Lousaing D, Lee Loy S. Limb Salvage for Massive Recurrent Distal Femoral Giant Cell Tumour Using Megaprosthetic Reconstruction in a Resource-Limited Setting: A Case Report. SVOA Orthopaedics 2026, 6:5, 219-225. doi: 10.58624/SVOAOR.2026.06.029

Abstract

Giant cell tumour of bone is a locally aggressive neoplasm with a recognised risk of local recurrence. A 52 year-old female was referred to Fracture and Orthopaedic Clinic Limited with recurrent distal femoral giant cell tumour after two prior surgical procedures in the public health system. The patient reported first noticing pain and a mass around the distal femur in April 2024 and subsequently underwent two prior operations before referral, including tumour removal with bone cement placement followed by plate fixation after postoperative complications. Imaging demonstrated severe recurrent distal femoral destruction with extra osseous extension. She underwent wide en bloc resection, removal of previous fixation and distal femoral endoprosthetic reconstruction with a rotating-hinge knee mechanism. Amended external pathology supported recurrent giant cell tumour of bone, with H3F3A G34W positivity and no overt malignant features. At six-month follow-up, knee range of motion was 0-90 degrees and the Musculoskeletal Tumor Society (MSTS) lower-limb score was 28/30 (93.3%).

Keywords: giant cell tumour of bone; distal femur; recurrence; limb salvage; megaprosthesis; resource-limited setting