Optimal Treatment of Osteofibrous Dysplasia of the Tibia

Background:Our study of a large patient group reports on the behavior and postoperative recurrence of osteofibrous dysplasia (OFD).Methods:We reviewed the medical records of 55 patients who were diagnosed with OFD of the tibia and showed typical features of this tumor. The patients' presentation, disease course, history of pathologic fracture, typical radiographic features, surgical treatment history, and surgical results were investigated.Results:The longitudinal OFD lesion size peaks at a mean 13.3 years of age with a mean maximum proportionate size of 0.33. These lesions in 92% of the patients spontaneously presented with a stable disease course, while those in the other 8% continued increasing. There were no significant predictive factors of disease course. Among surgically treated lesions, we noted a higher rate of recurrence after curettage than after excision (P<0.001). Patients who underwent curettage and developed recurrence were significantly younger than those who did not (P=0.01).Conclusions:Our data suggest that observation can be the primary form of treatment for patients with OFD and that the disease would stop advancing with time. During observation, clinicians should carefully observe all patients with OFD because the relation between OFD and adamantinoma is unclear. If surgery is necessary due to severe morbidity, we recommend excision rather than curettage to prevent recurrence, especially for younger patients.Level of Evidence:Level III.