Tratamiento de quistes óseos aneurismáticos con aloinjerto. [Treatment of aneurysmal bone cysts with allograft.]

Abstract

ResumenAntecedentes: Los pacientes con quiste óseo aneurismático plantean dificultades diagnósticas y terapéuticas. Se han descrito múltiples opciones terapéuticas. Objetivos: Evaluar los resultados obtenidos en pacientes tratados con curetaje y relleno con aloinjerto óseo. Materiales y Métodos: Se analizaron 16 quistes, correspondientes a 15 pacientes, con un seguimiento mínimo de 28 meses y una mediana de seguimiento de 83 meses. Resultados: La media de la edad era de 10 años (rango 3-16). La principal complicación fue la recidiva (37,5%), que fue más frecuente cuando existía compromiso fisario (62,5% frente al 12,5% sin compromiso; p = 0,05). La frecuencia de recidiva no varió en ambos sexos, para las distintas edades analizadas y respecto al uso o no de fresa de alta velocidad. Conclusión: Consideramos que el tratamiento realizado es seguro, pero tiene una alta tasa de recidivas, similar a las publicadas en otras series.Palabras clave: Quiste óseo aneurismático; aloinjerto. Nivel de Evidencia: IV Treatment of aneurysmal bone cysts with allograft AbstractBackround: Patients with aneurysmal bone cyst pose diagnostic and therapeutic difficulties. Multiple therapeutic options have been described. Objective: To evaluate the results obtained in patients treated with curettage and filling with bone allograft. Methods: Sixteen cysts, corresponding to 15 patients were evaluated, with a minimum follow-up of 28 months and a median follow-up of 83 months. Results: Average age was 10 years (range 3-16). The main complication was recurrence in 37.5% of patients, being more frequent with physeal involvement (62.5% vs. 12.5% without involvement; p = 0.05). The recurrence rate was unchanged for both sexes, for different ages and regarding the use or not of high-speed burr. Conclusion: We think that the treatment performed is safe, but recurrence rate is high, similar to that reported in other series.

Aneurysmal bone cyst: Is selective arterial embolization effective as curettage and bone grafting?

“…Curettage is still considered the standard of cure for ABC, but his recurrence rate ranging from 3% to 37% in the literature 25,26,36,37 . We found a recurrence rate of 24.7% in the curettage group.…”

“…30 Curettage is still considered the standard of cure for ABC, but his recurrence rate ranging from 3% to 37% in the literature. 25,26,36,37 We found a recurrence rate of 24.7% in the curettage group. Ramírez et al 38 got a global rate of recurrence of 27.5% in 29 patients treated with curettage plus bone grafting or bone resection, while Mankin et al revised a series of 150 primary ABCs treated mainly with curettage and implantation of chips of allograft or autograft or polymethylmethacrylate reporting a recurrence rate of 20%.…”