Transepiphyseal Curettage for Centrally Located Chondroblastomas: A Novel Approach with Excellent Functional Outcomes in Pediatric Patients

Background: Chondroblastoma is a rare, benign bone tumor predominantly affecting the epiphysis of children and adolescents. Traditional treatments often result in high recurrence rates and potential functional impairments, especially for centrally located lesions. Objectives: The present study evaluates a novel transepiphyseal curettage approach for centrally located chondroblastomas in the distal femur and proximal tibia. Methods: Thirteen pediatric patients (9 males, 4 females; mean age 11.5 years) with histologically confirmed centrally located chondroblastomas were treated using a transepiphyseal approach between 2017 and 2023, and follow-up periods ranged from 12 to 72 months (mean follow-up 36 months). The technique utilized fluoroscopy-guided transepiphyseal tunneling and curettage, followed by defect filling with calcium phosphate cement or cancellous bone allografts. Functional outcomes were assessed using standard orthopedic scoring systems. Results: Twelve patients demonstrated no recurrence, significant pain relief, and complete restoration of joint function. One patient experienced recurrence within 18 months, successfully treated with repeated curettage. Another patient developed a minor varus deformity without functional impairment, deferring the need for any corrective surgery until post-puberty. No significant complications were observed, such as infection, joint instability, or growth disturbances. Functional outcomes were excellent in 11 patients and good in 2. Conclusions: The transepiphyseal curettage approach provides direct access to centrally located chondroblastomas while preserving joint function and minimizing complications. This method shows a promisingly low recurrence rate and excellent functional outcomes, presenting a viable alternative to traditional and minimally invasive techniques. Further research with larger cohorts and longer follow-up is recommended to validate these findings.