Cortex and Cartilage Necrosis after Curettage with Combination of Phenol and High Speed Burr Adjuvant Thicker than Curettage only, Curettage and Phenol or Curettage and High Speed Burr Adjuvant on Distal Femoral Bovine Bone

Abstract Background: Curettage served as surgical management for benign tumor cases. The local recurrence rate of the tumor remains high without the use of adjuvant and the use of both chemical and mechanical adjuvants able to reduce it. However, excessive use of adjuvants may lead to complications, thus rational use of adjuvant is mandatory. This study aimed to explore the extent of cell death following the use of phenol, high speed burr, or combination. Methods: This was a pure experimental research with post-test only control group design with a total of 28 bovine bones which divided into four groups. Group 1 served as control and treated with curettage only. Group 2 was treated with curettage and phenol as adjuvant. Group 3 treated with curettage and high speed burr adjuvant, while group 4 treated with curettage, phenol and high speed burr as adjuvants. All samples were examined microscopically to determine the thickness of necrosis in cortex and cartilage. Results: The thickness of necrosis in all treatments group differ significantly when compared to control either in cortical or cartilage (p = 0.001 for all groups). No significant difference in necrotic thickness was found between phenol-treated group and high speed burr-treated group, both in cortical and cartilage (p = 0.59 and p = 1.00, respectively). Combination of phenol and high speed burr produced the thickest necrosis when compared with other group. Conclusion: Addition of adjuvants after curettage produced deeper necrosis effect. The use of combination of adjuvants should be carefully chosen since this procedure produced the thickest necrotic depth which may cause complication. Keywords: Necrosis; Curettage; Adjuvant; Phenol; High Speed Burr;