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Bumči, Igor; Vlahović, Tomislav

doi:10.1097/00004694-200201000-00026

Cited by 13 publications

(3 citation statements)

References 18 publications

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“…18 Decompression can be done with multiple drill holes, 12 cannulated screws, 19 and different types of nails. 20 Many mixed methods approach the cyst on multiple levels such as percutaneous removal of cyst lining, curettage to break up septations, intramedullary decompression, and injection of calcium sulfate pellets. 16 To date, few comparative studies have been conducted (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Treatment for unicameral bone cysts in long bones: an evidence based review

Donaldson

Chundamala²,

Yandow³

et al. 2010

Orthop Rev

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The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments.

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Section: Introductionmentioning

confidence: 99%

Treatment for unicameral bone cysts in long bones: an evidence based review

Donaldson

Chundamala²,

Yandow³

et al. 2010

Orthop Rev

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“…Besides, it was suggested that cyst fluid would play an important role in its pathogenesis. The interleukin 1, the prostaglandins and proteolytic enzymes present in the cyst would start a great resorptive activity in the affected bone [1,26]. According to these findings, the continuous drainage of the cyst fluid and the continuous decompression of the cyst seem to be a reasonable option for the treatment of these lesions.…”

Section: Discussionmentioning

confidence: 98%

Continuous decompression with intramedullary nailing for the treatment of unicameral bone cysts

Masquijo

Baroni

Miscione

2008

Journal of Children's Orthopaedics

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Purpose To evaluate the efficacy of decompression of unicameral bone cysts (UBCs) of the long bones with intramedullary nailing and to compare responses to treatment according to location. Materials and methods We evaluated 48 consecutive patients treated between January 1988 and June 2000. Mean age was 10.3 years. Mean follow-up was 9.8 years. Evaluation was performed according to the radiographic criteria of Capanna. Results UBCs were located in the proximal humerus (n = 24), humeral shaft (n = 2), proximal femur (n = 19), distal tibia (n = 2) and fibula (n = 1). A total of 62.5% presented a pathological fracture. Successful results were observed in 89.5% (26 total healing, 17 healing with residual radiolucent areas), and there were four recurrences and, in one case, no response to treatment. There was more healing in the humerus than in the femur (92.3% versus 84.2%), and more tendency to restitution ad integrum, although the difference was not statistically significant (P = 0.1499). Conclusions Intramedullary nailing is a minimally invasive method, which permits early stability and decompresses the cyst allowing healing. Significant differences were not observed among results from different locations.

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“…Arguments in favour of non-surgical treatment of juvenile bone cysts include very low complication rates and very few recurrences as confirmed by our meta-analysis, whereby 95% CI from 0 to 84% should be considered critically. In this regard, recurrence rates of 18–19% are cited in the literature whereby the figures are distinctly higher for female patients in the first decade of life [ 25 ]. It would seem essential to give each case careful consideration taking into account the patient’s previous history and assessing the patient’s desire to have surgery.…”

Section: Discussionmentioning

confidence: 99%

Management of juvenile and aneurysmal bone cysts: a systematic literature review with meta-analysis

Strohm

Kühle

et al. 2022

Eur J Trauma Emerg Surg

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Purpose Numerous approaches to the management of juvenile and aneurysmal bone cysts (ABC) are described in the specialist literature together with discussion of the associated healing and recurrence rates. Since there is currently no evidence-based treatment standard for these conditions, the aim of this systematic literature review with meta-analysis was to examine the different management approaches, evaluate the corresponding clinical outcomes and, as appropriate, to formulate a valid treatment recommendation. Methods A systematic search on OVID Medline® based on a pre-existing search strategy returned 1333 publications. Having defined inclusion and exclusion criteria and analysis of the relevant full texts, 167 publications were included in the descriptive analysis and 163 in the meta-analysis. For this purpose, different subgroups were created, based on the type of cyst and the therapeutic procedure. Those subgroups were then analysed in relation to their healing rates, the number of recurrences and complication rates. Results For aneurysmal bone cysts, both surgical removal and Doxycycline injection lead to excellent outcomes (98% healing) and low recurrence rates (6% and 11% resp.). Curettage (91% healing), including its combination with autologous cancellous bone graft (96% healing), showed very good healing rates but higher recurrence rates (22% and 15%, resp.), which were however improved by preoperative selective arterial embolization. A critical view must be taken of radiotherapy (90% healing) and the injection of alcohol (92% healing) because of their high complication rates (0.43/cyst and 0.42/cyst, resp.). In the management of juvenile bone cysts, surgical interventions like curettage and cancellous bone graft (87% healing) are far superior to non-surgical approaches (51% healing), furthermore, the application of autologous cancellous bone graft reduced the recurrence rate (3% recurrence) compared to curettage alone (20% recurrence). In subgroup analysis, treatment by ESIN was found to produce excellent outcomes (100% healing), though the patient collectives were small. Conclusion Surgical procedures to treat aneurysmal bone cysts appear to be the method of choice whereby Doxycycline injection may be an alternative. A surgical approach should be preferred in the treatment of juvenile bone cysts.

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Cited by 13 publications

References 18 publications

Treatment for unicameral bone cysts in long bones: an evidence based review

Treatment for unicameral bone cysts in long bones: an evidence based review

Continuous decompression with intramedullary nailing for the treatment of unicameral bone cysts

Management of juvenile and aneurysmal bone cysts: a systematic literature review with meta-analysis

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