Surgery: Unicameral Bone Cyst

Unicameral bone cyst treatment: injections, curettage, pathological fracture management. Dr. Priano, Milan.

Minimally invasive treatment for bone cysts

Surgical Techniques

Percutaneous Injections

Injection of corticosteroid, autologous bone marrow, or bone substitutes into the cyst cavity through needles under general anesthesia.

Indication

Symptomatic or fracture-risk cysts as first approach.

Recovery

Day hospital. Protected weight bearing for 2-4 weeks. May require repetition.

Curettage and Bone Grafting

Surgical emptying of the cyst and filling with autologous bone graft or substitutes.

Indication

Recurrent cysts, large cysts, or after failed injections.

Recovery

Protected weight bearing for 6-8 weeks. Healing rate >90%.

Postoperative Overview

Bone cyst treatment depends on size, location, activity, and fracture risk. Minimally invasive techniques (injections) are often the first approach. The choice between observation, injections, and surgery is discussed with the family based on the specific case.

Detailed Recovery Timeline

Note: The timeline below is a general baseline. The actual postoperative course varies depending on the specific surgical technique chosen (see procedures above).

Day-surgery for injections. 1 night for curettage.

Injections: Protected weight bearing 2-4 weeks. Curettage: Protected weight bearing 4-6 weeks with crutches.

Progressive weight bearing. X-ray to monitor healing. Injections may be repeated if needed.

Curettage: Usually healed by 3 months. Injections: May require repeat procedures (success rate 50-80% per injection).

Return to Sport

Injections: Return to sport 6-8 weeks. Curettage: 3 months. Contact sports only after confirmed healing.

Follow-up Schedule

Follow-ups at 6 weeks, 3 months, 6 months, 1 year. Monitor for recurrence, especially in 'active' cysts near growth plates.

Possible Complications

Injections: May require multiple procedures. Curettage: Rare recurrence, infection. Pathological fracture: Usually heals well and may help cyst resolution.

For parents