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Aneurysmal Bone Cysts Recur at Juxtaphyseal Locations in Skeletally Immature Patients

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Clinical Orthopaedics and Related Research

Abstract

Aneurysmal bone cysts are associated with a high rate of recurrence. Many aneurysmal bone cysts arise near open physes or articular cartilage in skeletally immature patients. Fear of damaging these structures could cause surgeons to curette the tumors less aggressively. We hypothesized location of an aneurysmal bone cyst in a periarticular or juxtaphyseal location would increase the risk of recurrence. We retrospectively studied 53 patients with aneurysmal bone cysts treated between 1989 and 2004. All patients had primary disease, and all patients underwent curettage of the lesion. Ten patients (18.9%) had local recurrence. Gender, race, and size did not predict recurrence; however 12 years of age or younger was associated with recurrence. Of the 19 juxtaphyseal cysts directly adjacent to an open physis, eight developed recurrence. Of the five periarticular cysts, two developed recurrence. The data suggest the risk of recurrence is highest in pediatric patients with juxtaphyseal or periarticular aneurysmal bone cysts. Meticulous treatment of these cysts is necessary, but we believe an overly aggressive approach that destroys the physis or articular cartilage is not warranted. Preservation of these structures remains a high priority of treatment.

Level of Evidence: Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Terri Robinson for assistance in preparation of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Unit 408, PO Box 301402, Houston, TX, 77230, USA

    Patrick P. Lin MD & Alan W. Yasko MD, MBA

  2. Howard University Surgical Society, Washington, DC, USA

    Christopher Brown BS

  3. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    A. Kevin Raymond MD & Michael T. Deavers MD

Authors
  1. Patrick P. Lin MD
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  2. Christopher Brown BS
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  3. A. Kevin Raymond MD
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  4. Michael T. Deavers MD
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  5. Alan W. Yasko MD, MBA
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Corresponding author

Correspondence to Patrick P. Lin MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.

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Lin, P.P., Brown, C., Raymond, A.K. et al. Aneurysmal Bone Cysts Recur at Juxtaphyseal Locations in Skeletally Immature Patients. Clin Orthop Relat Res 466, 722–728 (2008). https://doi.org/10.1007/s11999-007-0080-8

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  • DOI: https://doi.org/10.1007/s11999-007-0080-8

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