Curettage of benign lesions of bone. Factors related to recurrence

In a retrospective study of 155 patients with different types of benign lesions of bone, the rate of recurrence following simple curettage was analysed in relation to sex, age, histological type, the location and the size of the tumour, and the type of bone graft used at operation. All patients were followed for a minimum of 2 years, 131 (85%) for 5 years and 101 (65%) for 10 years or more. The overall rate of recurrence was 23%. All recurrences except one were within 6 years of the initial operation, 80% within 3 years and 49% within 1 year. The overall rate of cure using curettage as the sole treatment, although repeated several times in some cases, was 95%. Only 5% of the patients required more extensive surgery, such as local resection (6 cases) and amputation (1 case), to control the tumour. The histological type and the sex of the patient proved to be the only factors statistically related to recurrence, although with solitary cysts the age of the patient was also relevant. Significantly higher recurrence occurred with giant cell tumours and aneurysmal bone cysts, in females, and with solitary cysts in patients under 9 years of age. This study of histologically different benign lesions treated in a uniform manner at a single centre shows that the rate of recurrence is strongly related to the type of tumour. The choice of treatment in patients with benign lesions of bone should be dictated by the histological appearance of the lesion. More extensive surgical procedures may not be necessary but other measures may be used in addition to curettage.