Treatment of Unicameral Bone Cysts of the Calcaneus: A Systematic Review

Levy, David M.; Gross, Christopher; Garras, David N.

doi:10.1053/j.jfas.2014.10.014

Cited by 25 publications

(47 citation statements)

References 28 publications

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“…General treatment options reported in the literature include curettage in combination with autologous or allogenic grafting, the use of bone substitutes, autologous bone marrow injection, and numerous methods of cyst decompression including the use of cannulated screws or a cannulated hydroxyapatite pin [39–43]. The lack of a clear pathoetiology has impeded the development of a standard of care for solitary bone cysts amidst the numerous treatment strategies reported [1, 16, 40, 44]. With supporting evidence for a “trauma-hemorrhage” theory underlying SBC formation in the adult bone, surgical strategies, whenever necessary [1], may possibly be “downstaged” to minimally invasive ones, like prophylactic closed intramedullary nailing or bridge plating techniques for the diaphyseal lesion in a long bone or percutaneous reconstruction with grafts or bone substitutes as reported by some authors [42, 44, 45].…”

Section: Discussionmentioning

confidence: 99%

An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change

et al. 2017

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Background: Simple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now. Case presentation: A 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification. The patient was lost to follow-up but again sought consult after 3 years for the recurring complaint. On repeat radiographs, computed tomography (CT) scan, and MR images, tumor enlargement with cystic findings typical of simple bone cyst were documented. Diagnostic aspiration of the lesion was firstly done, revealing straw-colored fluid. The patient then underwent intralesional curettage with alpha-tricalcium phosphate cement reconstruction of the lytic defect. No perioperative complications were incurred, and on latest follow-up at 3 years postoperatively, Musculoskeletal Tumor Society (MSTS) and visual analog scale (VAS) pain scores were 30/30 and 0/10, respectively. Conclusions: The authors believe their report provides support to a possible association to trauma of simple bone cysts occurring in the adult population with closed physes and suggest this subset of patients may require a different treatment approach from that for juvenile simple bone cysts.

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Section: Discussionmentioning

confidence: 99%

An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change

et al. 2017

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“…In 2015 Levy et al conducted the first systematic review on the treatment of unicameral bone cysts of the calcaneus. His results clearly demonstrated that all patients who underwent operative curettage with bone substitute—whether autograft or allograft—enjoyed a statistically significant improvement in heel pain and demonstrated the best outcomes in his review regarding osteointegration and rate of recurrence (Levy et al 2015 ). Curettage with bone augmentation demonstrated significant improvements over curettage with cannulated-screw placement.…”

Section: Introductionmentioning

confidence: 99%

“…There is a strong predilection for the long bones of the proximal humerus and proximal femur, accounting for up to 85 % of all cases. The calcaneus is the sixth-most common UBC site, but it is the most common tarsal bone affected (Levy et al 2015 ). Localized at the lower extremities, UBC can cause persevering pain and thus justify surgical therapy (Sung et al 2008 ).…”

Section: Introductionmentioning

confidence: 99%

“…The type of intervention for unicameral bone cysts remains controversial (Levy et al 2015 ). General treatment options for UBC include curettage in combination with autologous or allogenic grafting, the use of bone substitutes, autologous bone-marrow injection and various methods of cyst decompression including cannulated screws or a cannulated hydroxyapatite pin (Chang et al 2002 ; Levy et al 2015 ; Pogoda et al 2004 ; Shirai et al 2015 ; Yildirim et al 2011 ). Nowadays most of these techniques can be performed percutaneously or minimally-invasive.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic resection and allografting for benign osteolytic lesions of the calcaneus

et al. 2016

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BackgroundBoth unicameral bone cysts and intra-osseous lipoma of the calcaneus are rare entities which are mostly diagnosed due to unspecific heel pain, pathologic fracture or as an incidental finding. Minimally-invasive ossoscopy with endoscopic resection of the tumor followed by grafting can potentially minimize risks of open surgery and speed up convalescence. The objective of this study is to present a simple, safe and cost-effective surgical technique for endoscopic surgical treatment of benign osteolytic lesions of the calcaneus.Description of techniqueWe present our modifications to previously described techniques of endoscopic curettage with a particular focus on intraosseous lipoma. The key point for grafting is the use of a funnel-shaped ear speculum facilitating the plombage with allogenic cancellous bone chips.Patients and methodsBetween June 2013 and January 2015 ten consecutive patients underwent ossoscopy of the calcaneus. There were 4 cases of intraosseous lipoma and 6 cases of unicameral bone cyst. In a retrospective study, radiological results were analyzed using the Glutting-Classification, functional outcome was recorded with the AOFAS Hindfoot score.ResultsRadiographic follow-up and functional outcome showed good to excellent results. All lesions radiologically classified as “healed”. AOFAS score (max. 100 pts) ranged from 74 to 100 (ø94.4 ± 9.3).ConclusionsThis technique is a simple and safe procedure for benign osteolytic bone lesions of the calcaneus. Compared to its alternatives, grafting with allogenic cancellous bone might prove favourable in this localization for several reasons: Osteointegration, handling, availability and costs. Our preliminary investigations show promising results although further clinical and radiographic results are needed.

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“…Conventional open curettage and plombage of a benign lytic calcaneal bone lesion is usually performed through a lateral surgical approach with a longitudinal or L-shaped skin incision and a fenestration of the lateral cortical wall of the calcaneus. 13 Prolonged wound healing and iatrogenic damage of the sural nerve are well-known complications for this localization. Furthermore, a large fenestration can weaken the cortical structures of the calcaneus additionally.…”

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confidence: 99%

Calcaneal Ossoscopy

Toepfer

Lenze²,

Harrasser³

2016

Arthroscopy Techniques

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Both unicameral bone cysts and intraosseous lipoma of the calcaneus are rare entities that are mostly diagnosed because of unspecific heel pain, pathologic fracture, or as incidental finding. Minimally invasive ossoscopy with endoscopic resection of the tumor followed by grafting can potentially minimize risks of open surgery and speed up convalescence. We present our modifications to previously described techniques of endoscopic curettage with a particular focus on intraosseous lipoma and allogenic grafting. The key point for grafting is the use of a funnel-shaped ear speculum facilitating the plombage with allogenic cancellous bone chips. Compared with its alternatives, grafting with allogenic cancellous bone might prove favorable in this localization for several reasons: osteointegration, handling, availability, and costs. The objective of this technical note is to present a simple, safe, and cost-effective surgical technique for endoscopic surgical treatment of benign osteolytic lesions of the calcaneus.

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Treatment of Unicameral Bone Cysts of the Calcaneus: A Systematic Review

Cited by 25 publications

References 28 publications

An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change

An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change

Endoscopic resection and allografting for benign osteolytic lesions of the calcaneus

Calcaneal Ossoscopy

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