Return to Sport and High-Demanding Activities After Curettage for Benign and Locally Aggressive Bone Tumors

Background: Intralesional curettage is a widely adopted surgical technique in orthopedic oncology. This study aims to evaluate patients’ ability to resume sports and high-demand physical activities after intralesional curettage. Traditional scoring systems, such as the MSTS score, may inadequately capture these performance-related aspects. Methods: This study analyzed all patients with benign and locally aggressive bone tumors treated with curettage at our institution between 2016 and 2024. Patients were classified according to histological diagnosis, lesion site, filling material, and the use of plates and screws for stabilization of the treated bone. Major postoperative complications and failures were reported. For each case, data on functional demands and sporting activities were collected using the UCLA Activity Score. UCLA Activity Scale scores were compared at T0, before neoplasm recognition; T1, before surgery; and T2, after surgery at the latest follow-up. Results: A total of 138 cases were included. The lower limb was involved in 73 cases and the upper limb in 65 cases. Stabilization with plates and screws was performed in 36 cases. Nine cases (6.5%) experienced postoperative complications. The mean UCLA Activity Scale score was 7.7 at T0, 5.1 at T1, and 7.0 at T2. Overall, 92 of 106 patients (86.8%) who regularly practiced sport before disease onset returned to their main pre-disease sport, although 25 of these 92 patients (27.2%) resumed it at a reduced frequency. Patients requiring internal fixation and those experiencing postoperative complications showed less favorable postoperative activity outcomes. Younger patients were more likely to match or increase their previous activity level. Conclusions: The impact of benign bone tumors and their surgical treatment on patients’ activity level is considerable. Curettage can restore limb function and allow a return to sport in most treated patients, especially younger patients, those without complications, and those without the need for internal fixation.