Skip to main content

Reply to the letter to the editor concerning the article “clinical outcomes of chondroblastoma treated using synthetic bone substitute: risk factors for developing radiographic joint degeneration”

The Original Article was published on 12 June 2021

To the Editor,

Thank you for providing us the opportunity to respond to the letter to the editor by Bo-Wen Zheng et al. We thank them for their interest in our study [1]. The main purpose of this study is to evaluate the safety and effects of using synthetic bone substitute (SBS) on adjacent-joint for filling the cavity after curettage of chondroblastoma, which often develops around a joint [2]. Due to the rarity of this disease, we were able to collect only 40 patients for analyses and we agree with the weak statistical power and lack of a control group as they mentioned. Therefore, we acknowledged these limitations in the last part of the discussion. In addition, in the discussion, we compared the incidence of radiographic degeneration in our cohort to that of previous case series and found low incidence in our cohort [3]. Accordingly, we concluded SBS can be used safely around a joint. They also suggested prospective controlled studies with large samples. However, considering the rarity of this disease, conducting a randomized clinical trial with well-controlled tumor background seems to be difficult. Regarding the cut-off point of age, we used 14 years because younger age (less than 14 years) was mentioned as a risk factor of local recurrence [4]. We again thank Bo-Wen Zhen et al. for their interest in our study, and we hope our small retrospective case series would be helpful when surgeon plans to use SBS for surgery of chondroblastoma.


  1. Outani H, Kakunaga S, Hamada K, Takenaka S, Nakai S, Yasuda N, et al. Clinical outcomes of chondroblastoma treated using synthetic bone substitute: risk 81factors for developing radiographic joint degeneration. World Surg Oncol. 2020;18(1):47.

    Article  Google Scholar 

  2. Xu H, Nugent D, Monforte HL, Binitie OT, Ding Y, Letson GD, et al. Chondroblastoma of bone in the extremities: a multicenter retrospective study. J Bone Joint Surg Am. 2015;97(11):925–31.

    Article  PubMed  Google Scholar 

  3. Farfalli GL, Slullitel PA, Muscolo DL, Ayerza MA, Aponte-Tinao LA. What happens to the articular surface after curettage for epiphyseal chondroblastoma? A reporton functional results, arthritis, and arthroplasty. Clin Prthop Relat Res. 2017;475(3):760–6.

    Article  Google Scholar 

  4. Suneja R, Grimer RJ, Belthur M, Jeys L, Carter SR, Tillman RM, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Joint Surg Br. 2005;87(7):974–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations



The author(s) read and approved the final manuscript.

Corresponding author

Correspondence to Hidetatsu Outani.

Ethics declarations

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Outani, H., Kakunaga, S., Imura, Y. et al. Reply to the letter to the editor concerning the article “clinical outcomes of chondroblastoma treated using synthetic bone substitute: risk factors for developing radiographic joint degeneration”. World J Surg Onc 19, 172 (2021).

Download citation

  • Published:

  • DOI: