Limb Salvage in Benign Bone Tumors

This chapter reviews the evolving role of limb salvage in benign and low-grade malignant bone tumors, emphasizing the balance between oncological control and preservation of function. Intralesional curettage remains the cornerstone of treatment, particularly for lesions such as giant cell tumor, aneurysmal bone cyst, chondroblastoma, and low-grade chondrosarcoma, where wide resection would cause disproportionate morbidity. The chapter outlines a stepwise surgical protocol for curettage, incorporating cortical window creation, meticulous debridement, high-speed burring, lavage, and adjuvant use to minimize recurrence. Local adjuvants including phenol, cryotherapy, argon beam coagulation, and polymethylmethacrylate are critically assessed for efficacy, safety, and limitations, with emphasis on the primacy of thorough mechanical clearance. Strategies for defect reconstruction are also detailed, comparing cement, autografts, allografts, and synthetic substitutes, and highlighting composite techniques for complex cases. In addition, percutaneous image-guided interventions such as polidocanol sclerotherapy for aneurysmal bone cysts and radiofrequency ablation for osteoid osteoma are discussed as minimally invasive, effective alternatives to open surgery. By synthesizing surgical and percutaneous approaches, this chapter provides a comprehensive framework for managing benign bone tumors with durable oncologic safety, optimized function, and reduced morbidity.