Soft Bone Tumors in Children's Knees: Key Questions Answered

Knee chondroma

Hello Dr.
Lee: I have a few questions regarding my 13-year-old son who has a soft bone growth on his right knee.
1: Is surgery appropriate for a 13-year-old? 2: Will the tumor disappear as he grows older? 3: How long will he need to stay in the hospital for the surgery, and how long should he rest before returning to school? Thank you!

danxin de mama, 30~39 year old female. Ask Date: 2005/09/30

Dr. Li Wenlin reply Orthopedics

Hello,
In response to your question, a 13-year-old with a chondroblastoma typically presents with an osteochondroma that most commonly arises on the lateral aspect of the proximal tibia.
Clinically, patients may report pain and localized swelling, but most cases are asymptomatic unless the tumor grows significantly.
There are two types of osteochondromas: solitary, where there is only one lesion and no others develop in different body parts, and multiple, where there are symmetrical lesions typically affecting both lower or upper limbs, often with a familial association.

The primary treatment for this type of osteochondroma is observation.
Before puberty, it is crucial to monitor the condition annually, as long as it does not compress nerves or blood vessels.
Generally, surgery is deferred until puberty when a complete excision can be performed.
If surgery is done before puberty and the tumor is not completely removed, there is a risk of recurrence.

At 13 years old, observation can still be considered; however, if there is significant compression of nerves or blood vessels, or if the tumor has caused pain or mobility issues, or if there is a suspicion of transformation, early surgical intervention is safer.
Osteochondromas do not disappear with age, but they typically do not grow much after puberty.
The surgery itself is relatively straightforward, involving the removal of the tumor along with its base.
Generally, with careful surgical technique, recovery to normal activities can occur in about two weeks, and hospitalization usually lasts only two to three days.

Wishing your son a speedy recovery!

Reply Date: 2005/09/30

More Info

Hello! Thank you for reaching out with your questions regarding your 13-year-old son’s soft bone tumor on his knee. I understand that this can be a concerning situation, and I hope to provide you with some clarity on the matter.

1. Is Surgery Appropriate for a 13-Year-Old?
At 13 years old, your son is at an age where surgical intervention can be considered, especially if the tumor is causing discomfort, functional limitations, or cosmetic concerns. The decision to proceed with surgery typically depends on several factors, including the size and location of the tumor, whether it is causing pain or affecting mobility, and the potential for future growth. In many cases, benign bone tumors like osteochondromas (which are common in children) can be surgically removed if they are symptomatic or if they pose a risk of complications, such as fractures or joint issues.

2. Will the Tumor Disappear with Age?
Many benign bone tumors, including osteochondromas, often stop growing once skeletal maturity is reached, which typically occurs in late adolescence. While some tumors may shrink or become less prominent over time, it is not guaranteed that they will completely disappear. Regular monitoring through physical examinations and imaging studies (like X-rays) is essential to assess any changes in the tumor's size or characteristics. If the tumor is asymptomatic and not causing any issues, a "watchful waiting" approach may be taken, but if it continues to grow or causes problems, surgical intervention may be necessary.

3. How Long Will Hospitalization and Recovery Take?
The length of hospital stay following surgery for a soft bone tumor can vary depending on the complexity of the procedure and the individual’s overall health. Generally, if the surgery is straightforward and there are no complications, your son might be able to go home the same day or after an overnight stay. Recovery time before returning to school can also vary; typically, children can return to school within a few days to a week post-surgery, depending on how he feels and the extent of the surgery. However, physical activity and sports should be avoided for a longer period, often several weeks to months, to allow for proper healing.

Additional Considerations:
- Post-Operative Care: After surgery, it’s crucial to follow the surgeon’s recommendations regarding rest, pain management, and physical therapy. Rehabilitation may be necessary to regain strength and range of motion in the knee.

- Follow-Up Appointments: Regular follow-ups with the orthopedic surgeon will be important to monitor healing and ensure that there are no complications.

- Emotional Support: It’s also essential to provide emotional support to your son during this time, as dealing with a tumor and potential surgery can be stressful for children.

In conclusion, while surgery can be a viable option for your son, the decision should be made in consultation with a pediatric orthopedic specialist who can evaluate his specific situation. They will provide the best guidance based on the tumor's characteristics and your son’s overall health. I wish you and your son all the best, and I hope for a smooth process ahead!

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