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Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Predictive characteristic of simple bone cyst treated with curettage and bone grafting

Authors: Pawel Flont, Krzysztof Malecki, Anna Niewola, Zbigniew Lipczyk, Kryspin Niedzielski

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

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Abstract

Background

The efficiency of treating simple bone cyst (SBC) is low. Depending on the choice of treatment, a positive response occurs in 20 to 80 % of cases. These rates are unacceptable, particularly considering they concern the treatment of benign lesions affecting children. Although cyst curettage is one of the first known ways of treating SBC, no precise qualification criteria exists for this procedure. The aim of our study is to identify which type of cyst may be most effectively treated using curettage with grafting.

Methods

A retrospective analysis was performed on 24 patients referred to our clinic for SBC treatment. To identify predictive factors, the group of patients who positively responded to treatment (Neer stages I and II, n = 14) were compared with the group in which recurrences occurred (Neer stages III and IV, n = 10).

Results

Significantly fewer patients with lesions located in the humerus (chi2 = 9.351; p <0.05) and without pathological facture at the time of diagnosis (p = 0.017) were found in the group with no recurrence. The following radiological parameters were found to vary significantly between groups: cyst area (z = 3.121; p < 0.01), cyst index (z = 2.213; p <0.05) and cyst diameter ratio (z = 2.202; p <0.05). In the group with no recurrences, the mean values of these parameters were found to be lower than in group with poor response to treatment. No statistically significant differences regarding age, sex or type of bone graft (p > 0.05) were found. Recurrences were experienced by 10 patients (41.7 %) during the 3-year period after surgery

Conclusion

In the group treated with curettage, associations were identified between worse treatment results and the location in the humerus, pathological fractures at the time of diagnosis, large cyst area, large cyst index and large cyst diameter.
Literature
1.
go back to reference Zehetgruber H, Bittner B, Gruber D, Krepler P, Trieb K, Kotz R, et al. Prevalence of aneurysmal and solitary bone cysts in young patients. Clin Orthop Relat Res. 2005;439:136–43.CrossRefPubMed Zehetgruber H, Bittner B, Gruber D, Krepler P, Trieb K, Kotz R, et al. Prevalence of aneurysmal and solitary bone cysts in young patients. Clin Orthop Relat Res. 2005;439:136–43.CrossRefPubMed
2.
go back to reference Cohen J. Simple bone cysts. Studies of cyst fluid in six cases with a theory of pathogenesis. J Bone Joint Surg Am. 1960;42:609–15.PubMed Cohen J. Simple bone cysts. Studies of cyst fluid in six cases with a theory of pathogenesis. J Bone Joint Surg Am. 1960;42:609–15.PubMed
3.
go back to reference Chigira M, Maehara S, Arita S, Udagawa E. The aetiology and treatment of simple bone cysts. J Bone Joint Surg Br. 1983;65:633–37.PubMed Chigira M, Maehara S, Arita S, Udagawa E. The aetiology and treatment of simple bone cysts. J Bone Joint Surg Br. 1983;65:633–37.PubMed
4.
go back to reference Watanabe H, Arita S, Chigira M. Aetiology of a simple bone cyst. Case Report. 1994;18:16–9. Watanabe H, Arita S, Chigira M. Aetiology of a simple bone cyst. Case Report. 1994;18:16–9.
5.
go back to reference Shindell R, Huurman WW, Lippiello L, Connolly JF. Prostaglandin levels in unicameral bone cysts treated by intralesional steroid injection. J Pediatr Orthop. 1989;9:516–19.CrossRefPubMed Shindell R, Huurman WW, Lippiello L, Connolly JF. Prostaglandin levels in unicameral bone cysts treated by intralesional steroid injection. J Pediatr Orthop. 1989;9:516–19.CrossRefPubMed
6.
go back to reference Komiya S, Minamitani K, Sasaguri Y, Hashimoto S, Morimatsu M, Inoue A. Simple bone cyst. Treatment by trepanation and studies on bone resorptive factors in cyst fluid with a theory of its pathogenesis. Clin Orthop Relat Res. 1993;287:204–11.PubMed Komiya S, Minamitani K, Sasaguri Y, Hashimoto S, Morimatsu M, Inoue A. Simple bone cyst. Treatment by trepanation and studies on bone resorptive factors in cyst fluid with a theory of its pathogenesis. Clin Orthop Relat Res. 1993;287:204–11.PubMed
7.
go back to reference Komiya S, Kawabata R, Zenmyo M, Hashimoto S, Inoue A. Increased concentrations of nitrate and nitrite in the cyst fluid suggesting increased nitric oxide synthesis in solitary bone cysts. J Orthop Res. 2000;18:281–88.CrossRefPubMed Komiya S, Kawabata R, Zenmyo M, Hashimoto S, Inoue A. Increased concentrations of nitrate and nitrite in the cyst fluid suggesting increased nitric oxide synthesis in solitary bone cysts. J Orthop Res. 2000;18:281–88.CrossRefPubMed
8.
go back to reference Richkind KE, Mortimer E, Mowery-Rushton P, Fraire A. Translocation (16;20)(p11.2;q13). sole cytogenetic abnormality in a unicameral bone cyst. Cancer Genet Cytogenet. 2002;137:153–55.CrossRefPubMed Richkind KE, Mortimer E, Mowery-Rushton P, Fraire A. Translocation (16;20)(p11.2;q13). sole cytogenetic abnormality in a unicameral bone cyst. Cancer Genet Cytogenet. 2002;137:153–55.CrossRefPubMed
9.
go back to reference Vayego SA, De Conti OJ, Varella-Garcia M. Complex cytogenetic rearrangement in a case of unicameral bone cyst. Cancer Genet Cytogenet. 1996;86:46–9.CrossRefPubMed Vayego SA, De Conti OJ, Varella-Garcia M. Complex cytogenetic rearrangement in a case of unicameral bone cyst. Cancer Genet Cytogenet. 1996;86:46–9.CrossRefPubMed
10.
go back to reference Scaglietti O, Marchetti PG, Bartolozzi P. Final results obtained in the treatment of bone cysts with methylprednisolone acetate (depo-medrol) and a discussion of results achieved in other bone lesions. Clin Orthop Relat Res. 1982;165:33–42.PubMed Scaglietti O, Marchetti PG, Bartolozzi P. Final results obtained in the treatment of bone cysts with methylprednisolone acetate (depo-medrol) and a discussion of results achieved in other bone lesions. Clin Orthop Relat Res. 1982;165:33–42.PubMed
11.
go back to reference Shinozaki T, Arita S, Watanabe H, Chigira M. Simple bone cysts treated by multiple drill-holes. 23 cysts followed 2–10 years. Acta Orthop Scand. 1996;67:288–90.CrossRefPubMed Shinozaki T, Arita S, Watanabe H, Chigira M. Simple bone cysts treated by multiple drill-holes. 23 cysts followed 2–10 years. Acta Orthop Scand. 1996;67:288–90.CrossRefPubMed
12.
go back to reference Abdel-Wanis ME, Tsuchiya H, Uehara K, Tomita K. Minimal curettage, multiple drilling, and continuous decompression through a cannulated screw for treatment of calcaneal simple bone cysts in children. J Pediatr Orthop. 2002;22:540–43.PubMed Abdel-Wanis ME, Tsuchiya H, Uehara K, Tomita K. Minimal curettage, multiple drilling, and continuous decompression through a cannulated screw for treatment of calcaneal simple bone cysts in children. J Pediatr Orthop. 2002;22:540–43.PubMed
13.
go back to reference Lokiec F, Ezra E, Khermosh O, Wientroub S. Simple bone cysts treated by percutaneous autologous marrow grafting. A preliminary report. J Bone Joint Surg Br. 1996;78:934–37.CrossRefPubMed Lokiec F, Ezra E, Khermosh O, Wientroub S. Simple bone cysts treated by percutaneous autologous marrow grafting. A preliminary report. J Bone Joint Surg Br. 1996;78:934–37.CrossRefPubMed
14.
go back to reference Killian JT, Wilkinson L, White S, Brassard M. Treatment of unicameral bone cyst with demineralized bone matrix. J Pediatr Orthop. 1998;18:621–24.CrossRefPubMed Killian JT, Wilkinson L, White S, Brassard M. Treatment of unicameral bone cyst with demineralized bone matrix. J Pediatr Orthop. 1998;18:621–24.CrossRefPubMed
15.
go back to reference Altermatt S, Schwöbel M, Pochon JP. Operative treatment of solitary bone cysts with tricalcium phosphate ceramic. A 1 to 7 year follow-up. Eur J Pediatr Surg. 1992;2:180–82.CrossRefPubMed Altermatt S, Schwöbel M, Pochon JP. Operative treatment of solitary bone cysts with tricalcium phosphate ceramic. A 1 to 7 year follow-up. Eur J Pediatr Surg. 1992;2:180–82.CrossRefPubMed
16.
go back to reference Neer CS, Francis KC, Marcove RC, Terz J, Carbonara PN. Treatment of unicameral bone cyst. A follow-up study of one hundred seventy-five cases. J Bone Joint Am. 1966;48:731–45. Neer CS, Francis KC, Marcove RC, Terz J, Carbonara PN. Treatment of unicameral bone cyst. A follow-up study of one hundred seventy-five cases. J Bone Joint Am. 1966;48:731–45.
17.
go back to reference Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop Relat Res. 1986;204:25–36.PubMed Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop Relat Res. 1986;204:25–36.PubMed
18.
go back to reference Bovill DF, Skinner HB. Unicameral bone cysts. A comparison of treatment options. Orthop Rev. 1989;18:420–27.PubMed Bovill DF, Skinner HB. Unicameral bone cysts. A comparison of treatment options. Orthop Rev. 1989;18:420–27.PubMed
19.
go back to reference Mylle J, Burssens A, Fabry G. Simple bone cysts. A review of 59 cases with special reference to their treatment. Arch Orthop Trauma Surg. 1992;111:297–300.CrossRefPubMed Mylle J, Burssens A, Fabry G. Simple bone cysts. A review of 59 cases with special reference to their treatment. Arch Orthop Trauma Surg. 1992;111:297–300.CrossRefPubMed
20.
go back to reference Enneking WF. A system of staging musculoskeletal. Clin Orthop Relat Res. 1986;204:9–24.PubMed Enneking WF. A system of staging musculoskeletal. Clin Orthop Relat Res. 1986;204:9–24.PubMed
21.
go back to reference Kaelin AJ, MacEwen GD. Unicameral bone cysts. Natural history and the risk of fracture. Int Orthop. 1989;13:275–82.CrossRefPubMed Kaelin AJ, MacEwen GD. Unicameral bone cysts. Natural history and the risk of fracture. Int Orthop. 1989;13:275–82.CrossRefPubMed
22.
go back to reference Kanellopoulos AD, Mavrogenis AF, Papagelopoulos PJ, Soucacos PN. Elastic intramedullary nailing and DBM-bone marrow injection for the treatment of simple bone cysts. World J Surg Oncol. 2007;5:111.PubMedCentralCrossRefPubMed Kanellopoulos AD, Mavrogenis AF, Papagelopoulos PJ, Soucacos PN. Elastic intramedullary nailing and DBM-bone marrow injection for the treatment of simple bone cysts. World J Surg Oncol. 2007;5:111.PubMedCentralCrossRefPubMed
23.
go back to reference Chang CH, Stanton RP, Glutting J. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. J Bone Joint Surg Br. 2002;84:407–12.CrossRefPubMed Chang CH, Stanton RP, Glutting J. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. J Bone Joint Surg Br. 2002;84:407–12.CrossRefPubMed
24.
go back to reference Schreuder HW, Conrad EU, Bruckner JD, Howlett AT, Sorensen LS. Treatment of simple bone cysts in children with curettage and cryosurgery. J Pediatr Orthop. 1997;17:814–20.PubMed Schreuder HW, Conrad EU, Bruckner JD, Howlett AT, Sorensen LS. Treatment of simple bone cysts in children with curettage and cryosurgery. J Pediatr Orthop. 1997;17:814–20.PubMed
25.
go back to reference Peltier LF, Jones RH. Treatment of unicameral bone cysts by curettage and packing with plaster-of-Paris pellets. J Bone Joint Surg Am. 1978;60:820–22.PubMed Peltier LF, Jones RH. Treatment of unicameral bone cysts by curettage and packing with plaster-of-Paris pellets. J Bone Joint Surg Am. 1978;60:820–22.PubMed
26.
go back to reference Oppenheim WL, Galleno H. Operative treatment versus steroid injection in the management of unicameral bone cysts. J Pediatr Orthop. 1984;4:1–7.CrossRefPubMed Oppenheim WL, Galleno H. Operative treatment versus steroid injection in the management of unicameral bone cysts. J Pediatr Orthop. 1984;4:1–7.CrossRefPubMed
27.
go back to reference Mik G, Arkader A, Manteghi A, Dormans JP. Results of a minimally invasive technique for treatment of unicameral bone cysts. Clin Orthop Relat Res. 2009;467:2949–54.PubMedCentralCrossRefPubMed Mik G, Arkader A, Manteghi A, Dormans JP. Results of a minimally invasive technique for treatment of unicameral bone cysts. Clin Orthop Relat Res. 2009;467:2949–54.PubMedCentralCrossRefPubMed
Metadata
Title
Predictive characteristic of simple bone cyst treated with curettage and bone grafting
Authors
Pawel Flont
Krzysztof Malecki
Anna Niewola
Zbigniew Lipczyk
Kryspin Niedzielski
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0797-6

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