Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2023; 14(9): 698-706
Published online Sep 18, 2023. doi: 10.5312/wjo.v14.i9.698
Sclerotherapy as a primary or salvage procedure for aneurysmal bone cysts: A single-center experience
Kolja Sebastian Weber, Claus Lindkær Jensen, Michael Mørk Petersen
Kolja Sebastian Weber, Claus Lindkær Jensen, Michael Mørk Petersen, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen 2100, Denmark
Author contributions: Weber KS designed and performed the research and wrote the paper. Jensen CL and Petersen MM designed the research, contributed to the analysis and supervised the report.
Institutional review board statement: The study was approved by the Danish Patient Safety Authority and the Data Protection Agency of the Capital Region of Copenhagen.
Informed consent statement: According to the Danish medical law and the institutional review board statement, this retrospective study did not require informed consent from the patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Kolja Sebastian Weber, MD, PhD, Surgeon, Department of Orthopedic Surgery, Rigshospitalet, Inge Lehmanns Vej 6, Copenhagen 2100, Denmark.
Received: July 3, 2023
Peer-review started: July 3, 2023
First decision: August 4, 2023
Revised: August 17, 2023
Accepted: August 23, 2023
Article in press: August 23, 2023
Published online: September 18, 2023
Research background

As an alternative to the traditional treatment of aneurysmal bone cysts (ABC), which consists of curettage with bone grafting, alternative treatment methods with promising results have been described. At our department, we have been using percutaneous sclerotherapy with polidocanol for primary and recurrent ABC. To our knowledge, this is the first larger series reporting on polidocanol as a salvage procedure.

Research motivation

The main challenge with aneurysmal bone cysts is their locally aggressive nature and a high risk of recurrence. Therefore, there is a need to find evidence for the best available treatment, which optimally shows high efficacy and at the same time low morbidity and low rates of recurrence.

Research objectives

The main objective was to identify the efficacy and safety of sclerotherapy with polidocanol in primary and recurrent ABC. The outcomes of this study, especially regarding recurrent ABC, propose sclerotherapy as a relevant treatment method to be considered.

Research methods

This is a single-center retrospective study, where all patients treated for ABC with percutaneous sclerotherapy from 2016-2021 were included. The data was collected through review of the electronic medical records.

Research results

In our series, sclerotherapy with polidocanol showed the ability to achieve healing or stable disease in 96% of cases (100% in primary ABC and 92% in recurrent ABC). These results support the positive experience with sclerotherapy for primary ABC in the recent literature and open the debate about sclerotherapy as a possible salvage treatment. The median length of radiographic follow-up was 19.5 mo. Further studies with longer follow-up are needed to decide if this provides a long-lasting effect.

Research conclusions

Based on the present study, sclerotherapy with polidocanol may also be considered as a salvage procedure for failed surgery or multiple recurrences. This can be a valuable alternative to other salvage treatment methods, which may have higher morbidity.

Research perspectives

Given the variety of possible treatment methods, future research should focus on randomized clinical trials to identify the gold standard treatment for primary and recurrent ABC.