Aneurysmal bone cysts (ABC): Retrospective analysis of two hundred and fifty eight cases.

IF 2.6 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-09-01 Epub Date: 2025-07-11 DOI:10.1007/s00264-025-06603-3

Mustafa Onur Karaca, Orhun Eray Bozkurt, Merve Dursun Savran, Mustafa Özyıldıran, Kerem Başarır, Hüseyin Yusuf Yıldız

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Abstract

Purpose: Aneurysmal bone cysts (ABCs) are bone tumours characterised by blood-filled cystic lesions. Management strategies for ABCs vary widely and lack consensus. This study aims to evaluate outcomes in 258 patients and investigate the factors affecting the recurrence rates.

Methods: This study is a single-centre retrospective analysis of patients diagnosed with ABC between January 1990 and December 2020. Patients who were histologically diagnosed with ABC, had available pathology, radiology, and surgery records, and were followed up for at least 24 months were included. Secondary ABCs were excluded. Presenting symptoms and location, computerised tomography (CT) and magnetic resonance imaging (MRI), treatment modalities, and recurrence were investigated.

Results: The mean age of the 258 ABC patients was 17.25 ± 12.37 years, 67.44% being under 18 years, and 12.40% under five years. 49.45% were female. The average follow-up duration was 47.80 ± 41.92 months. Pain was the most common presenting symptom, reported by 79.97% of patients. 5.04% were asymptomatic and diagnosed incidentally, whereas 11.63% were diagnosed following a pathological fracture. The median disease-free survival was ten months, with the average time to first recurrence being 24.22 ± 22.14 months. Recurrence was more common in patients under five years of age (34.38% vs. 19.03%, p = 0.046) and in those with pathologic fractures (40.00% vs. 18.42%, p = 0.006). Conversely, recurrence was less common when burr and/or cautery was added to curettage (31.97% vs. 11.03%, p < 0.001). Time to recurrence was significantly shorter in cases with soft tissue oedema (median 5 vs. 12 months, p = 0.010) or fluid-fluid levels (median 6 vs. 12 months, p = 0.038).

Conclusions: The study found that pathological fractures and age under five years are associated with a higher risk of recurrence in aneurysmal bone cysts. Electrocauterization and/or high-speed burring as local adjuvant therapy is associated with low recurrence rates.

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动脉瘤性骨囊肿（ABC）：回顾性分析258例。

目的：动脉瘤性骨囊肿（ABCs）是一种以充血囊性病变为特征的骨肿瘤。abc的管理策略差异很大，缺乏共识。本研究旨在评估258例患者的预后，并探讨影响复发率的因素。方法：本研究对1990年1月至2020年12月诊断为ABC的患者进行单中心回顾性分析。组织学诊断为ABC的患者，有可用的病理、放射学和手术记录，并随访至少24个月。次要abc排除在外。研究了症状和部位、计算机断层扫描（CT）和磁共振成像（MRI）、治疗方式和复发情况。结果：258例ABC患者平均年龄为17.25±12.37岁，18岁以下占67.44%，5岁以下占12.40%。49.45%为女性。平均随访时间为47.80±41.92个月。疼痛是最常见的症状，占79.97%。5.04%无症状，是偶然诊断的，而11.63%是病理性骨折后诊断的。中位无病生存期为10个月，至首次复发的平均时间为24.22±22.14个月。5岁以下患者复发率最高（34.38%比19.03%,p = 0.046），病理性骨折患者复发率最高（40.00%比18.42%,p = 0.006）。相反，当刮除术中加入毛刺和/或烧灼时，复发率较低（31.97% vs. 11.03%）。结论：研究发现病理性骨折和5岁以下年龄与动脉瘤性骨囊肿复发的风险较高相关。电灼和/或高速毛刺作为局部辅助治疗与低复发率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.