The Natural History of Unicameral Bone Cyst After Steroid Injection

Capanna, Rodolfo; A, Dal Monte; Gitelis, Steven; Campanacci, Mario

doi:10.1097/00003086-198206000-00036

Cited by 179 publications

(153 citation statements)

References 0 publications

Supporting

Mentioning

142

Contrasting

Unclassified

Order By: Relevance

“…Fracture of the cyst is one cause of failure after the first treatment; Neer et al [27] reported up to 80% of fractures in patients followed without surgical treatment. In patients surgically treated, fracture has been reported in 2.6% of cases treated with curettage and bone grafting [35]; from 7.7% [4] to 28% [41] and 33% [42] in patients treated with marrow or steroid injection. We observed no difference in the number of fractures that occurred in our series in the two groups (12% in the DBM + BMC Group versus 17% in the Steroid Group), resulting in the average of fractures reported in series dealing with patients treated with either steroid or bone marrow injection.…”

Section: Volume 468 Number 11 November 2010mentioning

confidence: 99%

“…One series comparing steroid to bone marrow injection reported a higher number of steroid injections required to achieve the final healing rate [6]. However, despite the differences in the evaluation method, most of the failures occurred within the first two years of followup as reported by other series [11,30], leaving a number of patients in the Neer III grade evaluation to be followed for a long time until evidence of definitive healing was achieved [3,4,27]. When considering factors with a negative effect on the treatment outcome, the humeral site did not score more fractures than other sites [5], although size, younger age and proximity to the growth plate confirmed their negative effect on the final healing rate requiring, despite fracture, a higher number of injections.…”

Section: Volume 468 Number 11 November 2010mentioning

confidence: 99%

“…As observed by Sung et al [35] there is not likely an age at which risk increases, although younger patients are more likely to need subsequent treatments to achieve final healing. This is also likely true for the size and proximity of the growth plate as these are generally considered signs of active cyst [4,16] although these differences would likely be significant only in larger study series. Finally, we believe it important to improve the operative technique by opening of the medullary canal from the diaphyseal side to reduce the pressure inside the lesion.…”

Section: Volume 468 Number 11 November 2010mentioning

confidence: 99%

“…Repeated percutaneous injection of corticosteroids was proposed by Scaglietti in 1979 [32]. Owing to the low morbidity, the simplicity, and the high healing rate reported by Scaglietti (90%), this treatment has been widely used [3,4,41]. However, subsequent studies reported a lower healing rate for this procedure with only 41% to 63% healing after the first injection [6,13].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Injection of Demineralized Bone Matrix With Bone Marrow Concentrate Improves Healing in Unicameral Bone Cyst

Bella

Dozza

Frisoni

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Unicameral bone cysts are benign lesions that usually spontaneously regress with skeletal maturity; however, the high risk of pathologic fractures often justifies treatment that could reinforce a weakened bone cortex. Various treatments have been proposed but there is no consensus regarding the best procedure. Questions/purposes We compared the healing rates and failures of two methods of cure based on multiple injections of corticosteroid or a single injection of demineralized bone matrix (DBM) in association with bone marrow concentrate (BMC). Methods We retrospectively reviewed 184 patients who had one of the two treatments for unicameral bone cysts with cortical erosion. Clinical records were reviewed for treatment failures and radiographs for healing in all patients. The minimum followup was 12 months for the Steroids Group (mean, 48 months; range, 12-120 months) and 12 months for the DBM + BMC Group (mean, 20 months; range, 12-28 months).Results After one treatment we observed a lower healing rate of cysts treated with multiple injections of steroids compared with the healing after the first injection of DBM + BMC (21% versus 58%, respectively). At last followup, 38% healed with steroids and 71% with DBM + BMC. The rate of failure after one steroid injection was higher than after a single injection of BDM + BMC (63% versus 24%, respectively). We observed no difference in fracture rates after treatment between the two groups.

show abstract

Section: Volume 468 Number 11 November 2010mentioning

confidence: 99%

Section: Volume 468 Number 11 November 2010mentioning

confidence: 99%

Section: Volume 468 Number 11 November 2010mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Injection of Demineralized Bone Matrix With Bone Marrow Concentrate Improves Healing in Unicameral Bone Cyst

Bella

Dozza

Frisoni

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…5,7,20 These parameters were usually ignored in simple radiographic assessments. Recently, Keyak et al showed that FE modeling can predict fracture loads of proximal femurs with or without metastatic disease.…”

Section: Introductionmentioning

confidence: 99%

Novel Approach of Predicting Fracture Load in the Human Proximal Femur Using Non-Invasive QCT Imaging Technique

et al. 2009

View full text Add to dashboard Cite

Abstract-This paper presents an analysis of predicting the load-bearing capacities of human femurs using quantitative computer tomography (QCT)-based beam theory. Crosssectional images of 12 human cadaver femurs (intact bones, age: 39-77 years; male = 8, female = 4) were scanned in conjunction with a calcium hydroxyapatite phantom which has five chambers of known densities. The apparent densities obtained from the scans were used to evaluate the Young's modulus (E) by applying the established empirical relationships. The fracture load of a configuration that simulated single-legged stance was measured experimentally and compared with the predicted failure load using a composite beam theory, plane stress model of the femur. In this model, the failure was assumed to occur at the weakest cross-section through the bone determined from QCT-based structural analysis. In contrast to the other experimental investigations, the setup used in this study considers the entire length of a human femur and also incorporates a novel mechanical jig to mimic the realistic physiological scenario. In one of our earlier studies, simulated lytic defects of varying size were created at the inter-trochanteric region of femurs and their load-bearing capacities were calculated based on their structural properties. Both the results obtained from the current study as well as the ones from our previous study were used to assess the viability of the methodology. A high degree of correlation was observed when the predicted failure loads obtained from the intact femurs and previously studied defective femurs were compared with the ex vivo fracture loads. The coefficients of determination (R 2 ) of QCT-derived predicted loads with respect to the measured failure loads were 0.80 for the intact femurs and 0.87 for the defective femurs. The results suggest that the QCT-derived beam analysis provides a viable approach for the assessment of load-bearing capacity in various clinical scenarios.

show abstract

Interventions for treating simple bone cysts in the long bones of children

Zhao

Wang

Huang

et al. 2017

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

The available evidence is insufficient to determine the relative effects of bone marrow versus steroid injections, although the bone marrow injections are more invasive. Noteably, the rate of radiographically assessed healing of the bone cyst at two years was well under 50% for both interventions. Overall, there is a lack of evidence to determine the best method for treating simple bone cysts in the long bones of children. Further RCTs of sufficient size and quality are needed to guide clinical practice.

show abstract

The Natural History of Unicameral Bone Cyst After Steroid Injection

Cited by 179 publications

References 0 publications

Injection of Demineralized Bone Matrix With Bone Marrow Concentrate Improves Healing in Unicameral Bone Cyst

Injection of Demineralized Bone Matrix With Bone Marrow Concentrate Improves Healing in Unicameral Bone Cyst

Novel Approach of Predicting Fracture Load in the Human Proximal Femur Using Non-Invasive QCT Imaging Technique

Interventions for treating simple bone cysts in the long bones of children

Contact Info

Product

Resources

About