Treatment Options in Unicameral Bone Cysts

Farber, Jeffrey M.; Stanton, Robert P.

doi:10.3928/0147-7447-19900101-06

Cited by 41 publications

(16 citation statements)

References 14 publications

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“…Only one study examined MPA injection outcome with and without inner wall disruption [47] and the outcome success was comparable. Five studies examined the difference in outcome of curettage with allograft compared to autograft [3, 9, 14, 25, 27], and the success rate was comparable (Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…Five articles compared the outcome of MPA injection relative to surgical curettage with autograft [14, 19, 25, 27, 47] (Fig. 4), and five articles also examined the outcome of MPA injection compared to surgical curettage with allograft [14, 25, 27, 29, 37] (Fig. 5).…”

Section: Resultsmentioning

confidence: 99%

“… Data were retrieved from these references: [6, 8, 9, 12, 13, 15, 21, 24, 25, 27, 30, 31, 38, 42, 43, 45, 46, 51, 54, 61, 65, 67] MPA methylprednisolone, DBM demineralized bone matrix, IM nail Intramedulary nail, Screws continuous decompression with cannulated screws aThe exact location of the cyst was not determined in all the papers; therefore, the percentages did not add up to 100 % …”

Section: Resultsmentioning

confidence: 99%

“…Data were retrieved from these references: [6, 8, 9, 12, 13, 15, 21, 24, 25, 27, 30, 31, 38, 42, 43, 45, 46, 51, 54, 61, 65, 67]…”

Section: Resultsmentioning

confidence: 99%

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Treatment of unicameral bone cyst: Systematic review and meta analysis

Kadhim

Thacker

Kadhim³

et al. 2014

Journal of Children's Orthopaedics

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PurposeDifferent treatment modalities have been utilized to treat unicameral bone cyst (UBC), but evidence has not been fully described to support one treatment over another and the optimal treatment is controversial. The aim of this quantitative systematic review was to assess the effectiveness of different UBC treatment modalities.MethodsWe utilized Pubmed to isolate retrospective studies on patients with UBC who received any kind of treatment. The included studies needed to have a minimum sample size of 15 patients, and have provided data on radiographic healing outcome.ResultsSixty-two articles were selected for the meta-analysis from a total of 463 articles. The cumulative sample size was 3,211 patients with 3,217 UBC, and male to female ratio was 2.2:1. The summary or pool estimate of methylprednisolone acetate (MPA) injection resulted in a healing rate of (77.4 %) that was comparable to bone marrow injection (77.9 %). A higher healing rate was observed with MPA injection when inner wall disruption was performed. The pool estimate of bone marrow with demineralized bone matrix injection was high (98.7 %). UBC healing rate after surgical curettage was comparable whether autograft or allograft was utilized (90 %). UBC treatment with flexible intramedullary nails without curettage provided almost 100% healing rate, while continuous decompression with cannulated screws provided 89 % healing rate. Conservative treatment indicated a healing rate of 64.2, 95 % CI (26.7–101.8).ConclusionsActive treatment for UBC provided variable healing rates and the outcomes were favorable relative to conservative treatment. Due to the heterogeneity of the studies and reporting bias, the interpretation of these findings should be handled with caution.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Data were retrieved from these references: [6, 8, 9, 12, 13, 15, 21, 24, 25, 27, 30, 31, 38, 42, 43, 45, 46, 51, 54, 61, 65, 67]…”

Section: Resultsmentioning

confidence: 99%

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Treatment of unicameral bone cyst: Systematic review and meta analysis

Kadhim

Thacker

Kadhim³

et al. 2014

Journal of Children's Orthopaedics

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“…Further surgical treatment options include curettage and bone grafting or intralesional steroid injection. Farber reported in a series of 59 patients a healing rate of 53% when treated with curettage and bone grafting compared to 70% when treated with steroid injection [7].…”

Section: Discussionmentioning

confidence: 99%

Flexible intramedullary nailing for unicameral cysts in children's long bones

Glanzmann

Campos

2007

Journal of Children's Orthopaedics

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Purpose The purpose of this study was to evaluate the outcome of flexible intramedullary nailing for unicameral bone cysts in terms of function and osseous consolidation. Methods Twenty-two unicameral bone cysts in children's long bones were treated by flexible intramedullary nailing. In 13 cases the bone cyst was diagnosed in a traumatic event leading to a pathologic fracture. Fifteen patients were referred to our clinic after failed conservative treatment. In 16 patients the cyst was located in the humerus, and in 6 patients in the femur. Mean duration of follow-up after surgery was 24 months. Results According to Capanna's criteria healing was obtained in 20 cases with a mean time of 16 months. Sixteen cysts healed completely. Four lesions were classified as grade 2, meaning that residual radiolucencies were radiographically visible at the latest follow-up. Two recurrences of humeral cysts were seen at 16 and 18 months postoperatively. The complication rate was minimal. Conclusion Due to the immediate stabilization of the lesion aftercare becomes facile. This method allows prompt mobilization and early weight bearing without the necessity of a plaster cast. Further it prevents effectively the most common complication, a re-fracture or a pathologic fracture. Therefore we propose this surgical procedure as the treatment of choice for unicameral bone cysts in children's long bones.

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

Zhao¹,

Ding²,

Huang³

et al. 2014

Cochrane Database of Systematic Reviews

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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.

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Treatment Options in Unicameral Bone Cysts

Cited by 41 publications

References 14 publications

Treatment of unicameral bone cyst: Systematic review and meta analysis

Treatment of unicameral bone cyst: Systematic review and meta analysis

Flexible intramedullary nailing for unicameral cysts in children's long bones

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

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