Unicameral Bone Cyst: Diagnosis, Treatment, and Follow-Up Methods, a Multicenter Study

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Skeletal Radiology

Background:

• Unicameral bone cysts (UBC) are benign cystic lesions typically found in the metaphysis of long bones in children and adolescents.
• While often asymptomatic, pathological fractures are a common complication, necessitating effective diagnostic and treatment strategies.

Purpose of the Study:

• To compare the diagnostic accuracy, treatment modalities, and follow-up outcomes of unicameral bone cyst (UBC) cases across multiple clinical centers.
• To evaluate the effectiveness of conservative, percutaneous injection, and surgical interventions for UBC management.

Main Methods:

• A retrospective review of 180 unicameral bone cyst (UBC) cases in patients aged 0-20 from seven centers.
• Analysis of patient demographics, symptoms, diagnostic methods, treatment approaches, and follow-up data using Musculoskeletal Tumor Society (MSTS) scores and Capanna criteria.

Main Results:

• Radiographic imaging demonstrated 96.1% diagnostic accuracy for UBC. The humerus and femur were most commonly affected.
• Pathological fractures occurred in 35% of cases. Surgical treatment was employed in 49.2% of cases, followed by percutaneous injection (31.8%) and conservative management (19%).
• Average follow-up was 81 months, with surgical treatment yielding superior clinical outcomes compared to percutaneous injection.

Conclusions:

• Surgical intervention provides the best clinical outcomes for unicameral bone cysts (UBC), though percutaneous injection offers a less invasive alternative.
• Treatment strategies for UBC should be individualized based on patient-specific factors and lesion characteristics.