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Erschienen in: Clinical Orthopaedics and Related Research® 11/2009

01.11.2009 | Clinical Research

Results of a Minimally Invasive Technique for Treatment of Unicameral Bone Cysts

verfasst von: Gökçe Mik, MD, Alexandre Arkader, MD, Alexander Manteghi, BS, John P. Dormans, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 11/2009

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Abstract

Unicameral bone cysts are benign bone lesions commonly seen in pediatric patients. Several treatment methods have been described with variable results and high recurrence rates. We previously reported short-term success of a minimally invasive technique that includes combining percutaneous decompression and grafting with medical-grade calcium sulfate pellets. The purpose of this study was to review the additional long-term results with a minimum followup of 24 months (average, 37 months; range, 24–70 months). We identified 55 patients with an average age of 10.8 years (range, 1.3–18 years). Forty-one of 55 lesions occurred in the humerus and femur. Forty-four of 55 (80%) patients had a partial or complete response after initial surgery; of these, seven obtained a partial or complete response after a repeat surgery (cumulative healing rate, 94%). Two patients underwent a third surgery (cumulative healing rate, 98%). One underwent a third repeat surgery (cumulative healing rate, 100%). There were no major complications associated with the procedure. Two patients had a superficial infection that resolved with oral antibiotics. Although some patients required a repeat procedure, complete or partial response at a minimum 24 months’ followup was achieved in all patients.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Bumci I, Vlahovic T. Significance of opening the medullar canal in surgical treatment of simple bone cyst. J Pediatr Orthop. 2002;22:125–129.PubMedCrossRef Bumci I, Vlahovic T. Significance of opening the medullar canal in surgical treatment of simple bone cyst. J Pediatr Orthop. 2002;22:125–129.PubMedCrossRef
2.
Zurück zum Zitat Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop Relat Res. 1986;204:25–36.PubMed Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop Relat Res. 1986;204:25–36.PubMed
3.
Zurück zum Zitat Capanna R, Dal Monte A, Gitelis S, Campanacci M. The natural history of unicameral bone cyst after steroid injection. Clin Orthop Relat Res. 1982;166:204–211.PubMed Capanna R, Dal Monte A, Gitelis S, Campanacci M. The natural history of unicameral bone cyst after steroid injection. Clin Orthop Relat Res. 1982;166:204–211.PubMed
4.
Zurück zum Zitat Chang CH, Stanton RP, Glutting J. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. J Bone Joint Surg Br. 2002;84:407–412.PubMedCrossRef Chang CH, Stanton RP, Glutting J. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. J Bone Joint Surg Br. 2002;84:407–412.PubMedCrossRef
5.
Zurück zum Zitat Chigira M, Maehara S, Arita S, Udagawa E. The aetiology and treatment of simple bone cysts. J Bone Joint Surg Br. 1983;65:633–637.PubMed Chigira M, Maehara S, Arita S, Udagawa E. The aetiology and treatment of simple bone cysts. J Bone Joint Surg Br. 1983;65:633–637.PubMed
6.
Zurück zum Zitat Cho HS, Oh JH, Kim HS, Kang HG, Lee SH. Unicameral bone cysts: a comparison of injection of steroid and grafting with autologous bone marrow. J Bone Joint Surg Br. 2007; 89:222–226.PubMedCrossRef Cho HS, Oh JH, Kim HS, Kang HG, Lee SH. Unicameral bone cysts: a comparison of injection of steroid and grafting with autologous bone marrow. J Bone Joint Surg Br. 2007; 89:222–226.PubMedCrossRef
7.
Zurück zum Zitat Cohen J. Simple bone cysts: studies of cyst fluid in six cases with a theory of pathogenesis. J Bone Joint Surg Am. 1960;42:609–616.PubMed Cohen J. Simple bone cysts: studies of cyst fluid in six cases with a theory of pathogenesis. J Bone Joint Surg Am. 1960;42:609–616.PubMed
8.
Zurück zum Zitat de Sanctis N, Andreacchio A. Elastic stable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children?: prospective long-term follow-up study. J Pediatr Orthop. 2006;26:520–525.PubMed de Sanctis N, Andreacchio A. Elastic stable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children?: prospective long-term follow-up study. J Pediatr Orthop. 2006;26:520–525.PubMed
9.
Zurück zum Zitat Docquier PL, Delloye C. Treatment of simple bone cysts with aspiration and a single bone marrow injection. J Pediatr Orthop. 2003;23:766–773.PubMed Docquier PL, Delloye C. Treatment of simple bone cysts with aspiration and a single bone marrow injection. J Pediatr Orthop. 2003;23:766–773.PubMed
10.
Zurück zum Zitat Dormans JP, Dormans NJ. Use of percutaneous intramedullary decompression and medical-grade calcium sulfate pellets for treatment of unicameral bone cysts of the calcaneus in children. Orthopedics. 2004;27(1 suppl):s137–s139.PubMed Dormans JP, Dormans NJ. Use of percutaneous intramedullary decompression and medical-grade calcium sulfate pellets for treatment of unicameral bone cysts of the calcaneus in children. Orthopedics. 2004;27(1 suppl):s137–s139.PubMed
11.
Zurück zum Zitat Dormans JP, Sankar WN, Moroz L, Erol B. Percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate pellets for unicameral bone cysts in children: a new minimally invasive technique. J Pediatr Orthop. 2005;25:804–811.PubMedCrossRef Dormans JP, Sankar WN, Moroz L, Erol B. Percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate pellets for unicameral bone cysts in children: a new minimally invasive technique. J Pediatr Orthop. 2005;25:804–811.PubMedCrossRef
12.
Zurück zum Zitat Givon U, Sher-Lurie N, Schindler A, Ganel A. Titanium elastic nail: a useful instrument for the treatment of simple bone cyst. J Pediatr Orthop. 2004;24:317–318.PubMed Givon U, Sher-Lurie N, Schindler A, Ganel A. Titanium elastic nail: a useful instrument for the treatment of simple bone cyst. J Pediatr Orthop. 2004;24:317–318.PubMed
13.
Zurück zum Zitat Glaser DL, Dormans JP, Stanton RP, Davidson RS. Surgical management of calcaneal unicameral bone cysts. Clin Orthop Relat Res. 1999;360:231–237.PubMedCrossRef Glaser DL, Dormans JP, Stanton RP, Davidson RS. Surgical management of calcaneal unicameral bone cysts. Clin Orthop Relat Res. 1999;360:231–237.PubMedCrossRef
14.
Zurück zum Zitat Hashemi-Nejad A, Cole WG. Incomplete healing of simple bone cysts after steroid injections. J Bone Joint Surg Br. 1997;79:727–730.PubMedCrossRef Hashemi-Nejad A, Cole WG. Incomplete healing of simple bone cysts after steroid injections. J Bone Joint Surg Br. 1997;79:727–730.PubMedCrossRef
15.
Zurück zum Zitat Herring JA, Peterson HA. Simple bone cyst with growth arrest. J Pediatr Orthop. 1987;7:231–235.PubMed Herring JA, Peterson HA. Simple bone cyst with growth arrest. J Pediatr Orthop. 1987;7:231–235.PubMed
16.
Zurück zum Zitat Inoue O, Ibaraki K, Shimabukuro H, Shingaki Y. Packing with high-porosity hydroxyapatite cubes alone for the treatment of simple bone cyst. Clin Orthop Relat Res. 1993;293:287–292.PubMed Inoue O, Ibaraki K, Shimabukuro H, Shingaki Y. Packing with high-porosity hydroxyapatite cubes alone for the treatment of simple bone cyst. Clin Orthop Relat Res. 1993;293:287–292.PubMed
17.
Zurück zum Zitat Lokiec F, Ezra E, Khermosh O, Wientroub S. Simple bone cysts treated by percutaneous autologous marrow grafting: a preliminary report. J Bone Joint Surg Br. 1996;78:934–937.PubMedCrossRef Lokiec F, Ezra E, Khermosh O, Wientroub S. Simple bone cysts treated by percutaneous autologous marrow grafting: a preliminary report. J Bone Joint Surg Br. 1996;78:934–937.PubMedCrossRef
18.
Zurück zum Zitat Neer CS 2nd, Francis KC, Marcove RC, Terz J, Carbonara PN. Treatment of unicameral bone cyst: a follow-up study of one hundred seventy-five cases. J Bone Joint Surg Am. 1996;48:731–745. Neer CS 2nd, Francis KC, Marcove RC, Terz J, Carbonara PN. Treatment of unicameral bone cyst: a follow-up study of one hundred seventy-five cases. J Bone Joint Surg Am. 1996;48:731–745.
19.
Zurück zum Zitat Roposch A, Saraph V, Linhart WE. Flexible intramedullary nailing for the treatment of unicameral bone cysts in long bones. J Bone Joint Surg Am. 2000;82:1447–1453.PubMed Roposch A, Saraph V, Linhart WE. Flexible intramedullary nailing for the treatment of unicameral bone cysts in long bones. J Bone Joint Surg Am. 2000;82:1447–1453.PubMed
20.
Zurück zum Zitat Rougraff BT, Kling TJ. Treatment of active unicameral bone cysts with percutaneous injection of demineralized bone matrix and autogenous bone marrow. J Bone Joint Surg Am. 2002;84: 921–929.PubMed Rougraff BT, Kling TJ. Treatment of active unicameral bone cysts with percutaneous injection of demineralized bone matrix and autogenous bone marrow. J Bone Joint Surg Am. 2002;84: 921–929.PubMed
21.
Zurück zum Zitat Scaglietti O. Sull’ azione osteogenice dell’ acetato di prednisolone. Boll Soc Tosco-Umbra Chir. 1974;35:35–41. Scaglietti O. Sull’ azione osteogenice dell’ acetato di prednisolone. Boll Soc Tosco-Umbra Chir. 1974;35:35–41.
22.
Zurück zum Zitat Scaglietti O, Marchetti PG, Bartolozzi P. Final results obtained in the treatment of bone cysts with methylprednisolone acetate (depo-medrol) and a discussion of results achieved in other bone lesions. Clin Orthop Relat Res. 1982;165:33–42.PubMed Scaglietti O, Marchetti PG, Bartolozzi P. Final results obtained in the treatment of bone cysts with methylprednisolone acetate (depo-medrol) and a discussion of results achieved in other bone lesions. Clin Orthop Relat Res. 1982;165:33–42.PubMed
23.
Zurück zum Zitat Spence KF Jr, Bright RW, Fitzgerald SP, Sell KW. Solitary unicameral bone cyst: treatment with freeze-dried crushed cortical-bone allograft. A review of one hundred and forty-four cases. J Bone Joint Surg Am. 1976;58:636–641.PubMed Spence KF Jr, Bright RW, Fitzgerald SP, Sell KW. Solitary unicameral bone cyst: treatment with freeze-dried crushed cortical-bone allograft. A review of one hundred and forty-four cases. J Bone Joint Surg Am. 1976;58:636–641.PubMed
24.
Zurück zum Zitat Wilkins RM. Unicameral bone cysts. J Am Acad Orthop Surg. 2000;8:217–224.PubMed Wilkins RM. Unicameral bone cysts. J Am Acad Orthop Surg. 2000;8:217–224.PubMed
25.
Zurück zum Zitat Yandow SM, Lundeen GA, Scott SM, Coffin C. Autogenic bone marrow injections as a treatment for simple bone cyst. J Pediatr Orthop. 1998;18:616–620.PubMedCrossRef Yandow SM, Lundeen GA, Scott SM, Coffin C. Autogenic bone marrow injections as a treatment for simple bone cyst. J Pediatr Orthop. 1998;18:616–620.PubMedCrossRef
Metadaten
Titel
Results of a Minimally Invasive Technique for Treatment of Unicameral Bone Cysts
verfasst von
Gökçe Mik, MD
Alexandre Arkader, MD
Alexander Manteghi, BS
John P. Dormans, MD
Publikationsdatum
01.11.2009
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 11/2009
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1008-2

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