Surgical Treatment of an Aneurysmal Bone Cyst with Avascular Bone Graft

Ulici, Alexandru; Nahoi, Catalin Alexandru; Carp, Madalina; Fodor, Ioan; Dinu, Cristina

doi:10.21614/chirurgia.112.2.172

Cited by 10 publications

(10 citation statements)

References 7 publications

(12 reference statements)

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“…Curettage with or without bone grafting persists to be the most widely used treatment for ABCs (Park et al., 2016; Tsagozis & Brosjö, 2015; Wang, Marfori, Serrano, & Rubio, 2014) even if it seems to be not effective to avoid local recurrence. Multiple options have been proposed to reduce the risk of recurrence as high‐speed bur (Gibbs et al., 1999), large bone (Dormans, Hanna, Johnston, & Khurana, 2004), and adjuvant therapy (Chang et al., 2017; Cummings, Smith, & Heck, 2010; Ulici, Nahoi, Carp, Fodor, & Dinu, 2017); however, until now, there was no consensus regarding the best procedure. We therefore asked whether (1) a single injection of autologous BMC combined with DBM and PRF for treating ABCs would produce similar result in healing rates compared with curettage and bone grafting; (2) the minimal invasive approach leads to an increased risk of local recurrence; (3) evaluated the relationship of recurrence in relation to the site of the cyst, the age, and gender of the patients; and (4) the two techniques differ in terms of long‐term complication.…”

Section: Discussionmentioning

confidence: 99%

Is percutaneous injection of bone marrow concentrate, demineralized bone matrix and PRF an alternative to curettage and bone grafting for treating aneurysmal bone cyst?

Cevolani

Campanacci

Sambri³

et al. 2021

J Tissue Eng Regen Med

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To determine the efficacy and safety of a single injection with autologous bone marrow concentrate (BMC) combined with demineralized bone matrix (DBM) and platelet‐rich fibrin (PRF) compared to curettage and bone grafting for treating aneurysmal bone cysts (ABC). Two hundred thirty‐nine patients were treated with curettage and bone grafting (Curettage Group), and 21 with percutaneous injection of DBM associated with autologous BMC and PRF (DBM + BMC + PRF Group). All patients attended the outpatient clinic to assess ABC healing and clinical results at the first 3, 6, 9 and 18 months after surgery and then annually in the absence of symptoms. The mean follow‐up was 42 months for the Curettage Group (range 6–180 months) and 28 months for the DBM + BMC + PRF Group (range, 6–85 months). Out of the 21 patients who had injection with BMC, DBM, and PRF, 17 (80%) require no additional treatment and they were considered healed. Of the 239 patients treated with curettage and bone grafting after core needle or open biopsy, 177 (74%) were considered healed after the first treatment. Injection in comparison with curettage presented the same risk for local recurrence. The overall rate of local recurrence for all patients was 25%. Univariate and multivariate analyses showed a significant difference in local recurrence rates in patients younger than 15 years, and for the cyst located in the long bones of the lower limbs than the cyst located in the long bones of the upper limbs.

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Section: Discussionmentioning

confidence: 99%

Is percutaneous injection of bone marrow concentrate, demineralized bone matrix and PRF an alternative to curettage and bone grafting for treating aneurysmal bone cyst?

Cevolani

Campanacci

Sambri³

et al. 2021

J Tissue Eng Regen Med

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Section: Introductionunclassified

“…El tratamiento es variable; cuando el tumor es detectado en fases iniciales, el pronóstico es bueno y el tratamiento consiste en la exéresis tumoral, curetaje y relleno con injerto óseo o cementado de la cavidad [6]. En tumoraciones de gran tamaño, por lo general existe afectación estructural de articulaciones grandes; representando esto un desafío para el ortopedista, principalmente cuando se tiene como objetivo la conservación de la funcionabilidad articular [6,7]. En estos casos el tratamiento de elección consiste en la resección en bloque y reconstrucción con aloinjerto u autoinjerto; generalmente se opta por estos procedimientos cuando existe una lesión agresiva, recurrente, o con alto riesgo de fractura [8].…”

Section: Introductionunclassified

Caso Clínico: Quiste Óseo Aneurismático de Peroné Distal, Tratamiento con Aloinjerto Estructural

Carmona

Chamaidan

Vélez³

et al. 2019

Rev Med HJCA

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REVISTA MÉDICA HJCA RESUMEN INTRODUCCIÓN: El quiste óseo aneurismático es una neoplasia benigna que aparece con mayor frecuencia en la segunda década de vida. Clínicamente se presenta como una masa que produce dolor y deformidad de la extremidad afectada; radiológicamente se caracteriza por lesiones líticas con tabicaciones internas y abombamiento de la cortical. Se presenta un caso donde se realizó un aloinjerto estructural para el tratamiento de esta patología.CASO CLÍNICO: Paciente de sexo masculino, de 18 años de edad; con historia de 5 meses de evolución de dolor e impotencia funcional de extremidad inferior derecha; al examen físico se evidenció masa de 15 x 6 cm en tobillo derecho. La radiografía simple demostró una lesión lítica de tercio distal de peroné con adelgazamiento e insuflación de la cortical. El examen histopatológico fue positivo para células gigantes de tipo osteoclasto, cambios simplásticos, estroma miofibroblástico y extravasación eritrocitaria; datos compatibles con quiste óseo aneurismático.EVOLUCIÓN: Se realizó la resección en bloque de la masa tumoral del peroné, para la reconstrucción se utilizó un aloinjerto estructural más estabilización con placa de compresión dinámica y tornillo transindesmal; se realizó además una reconstrucción ligamentaria utilizando la técnica de Watson Jones. El paciente tuvo una evolución favorable, a los 16 meses del procedimiento se observó consolidación completa, además de una función articular conservada; no se evidenció recidiva en los 5 años posteriores de control. CONCLUSIÓN:El quiste óseo aneurismático es una patología benigna que siendo tratada en etapas iniciales, conlleva un mejor pronóstico y requiere de la realización de procedimientos quirúrgicos menos complejos. En pacientes con tumores de gran tamaño no es posible la realización de tratamientos convencionales; siendo la resección en bloque más la colocación de aloinjerto y estabilización ligamentaria, una alternativa terapéutica válida que permita preservar la extremidad.

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“…These therapies include surgical cryotherapy, 9 alcohol sclerotherapy, 10 selective arterial embolisation, 11 and use of denosumab. 12 Denosumab is an innovative therapeutic approach, which inhibits osteoclast function, and can have positive effects on the development of ABCs. The purpose of treatment is to stop extension of the lesion, prevent pathological bone fractures, reduce relapse, and most importantly, stop pain.…”

Section: Introductionmentioning

confidence: 99%

Aggressive development of an aneurysmal bone cyst of the proximal femur in a paediatric patient: a case report

et al. 2017

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We report development of an aneurysmal bone cyst (ABC) that was located in the proximal region of the femur in an 11-year-old girl. Over a period of 30 weeks, the ABC showed fulminant local progression, with destruction of the bone, which led to an abrupt loss of function of the left hip. The standard tumour treatment protocol was followed. We performed embolisation of the tumour followed by a biopsy, which confirmed the diagnosis of ABC. The outcome was negative with total destruction of the proximal third of the femur, despite repeating the embolisation. Because of the unfavourable local progression, a second biopsy was performed and we reconfirmed the initial diagnosis. The final decision regarding the therapeutic approach was total hip arthroplasty with femoral reconstruction with a prosthesis. Following this treatment, the patient’s outcome was favourable, with complete recovery of function and no local relapse.

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Surgical Treatment of an Aneurysmal Bone Cyst with Avascular Bone Graft

Cited by 10 publications

References 7 publications

Is percutaneous injection of bone marrow concentrate, demineralized bone matrix and PRF an alternative to curettage and bone grafting for treating aneurysmal bone cyst?

Is percutaneous injection of bone marrow concentrate, demineralized bone matrix and PRF an alternative to curettage and bone grafting for treating aneurysmal bone cyst?

Caso Clínico: Quiste Óseo Aneurismático de Peroné Distal, Tratamiento con Aloinjerto Estructural

Aggressive development of an aneurysmal bone cyst of the proximal femur in a paediatric patient: a case report

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