Open surgical treatment of unicameral bone cysts : A retrospective data analysis.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2023-08-31 DOI:10.1007/s00508-023-02267-4
Kevin Döring, Géraldine D Sturz, Gerhard Hobusch, Stephan Puchner, Reinhard Windhager, Catharina Chiari
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Abstract

Background: A variety of treatment options for unicameral bone cysts (UBC) exist. The controversy of open management of UBC is discussed. The aim of this study was to analyze a single institution's experience in the open surgical treatment of UBC.

Patients and methods: By retrospective analysis of the Vienna Bone and Soft Tissue Tumor Registry, 119 patients with open surgery and histologically verified UBC with a mean follow up of 4.8 years (range 1-30 years) were included. Lesion treatment failure was defined as surgically addressed UBC undergoing revision surgery due to persistence or recurrence.

Results: Local revision-free survival for lesion treatment failure was 93% after 1 year, 80% after 2 years, 60% after 5 years and 57% after 10 years. Of the patients 34 (29%) had at least 1 revision surgery due to lesion treatment failure. We found that patients with lesion treatment failure were younger (p = 0.03), had UBC with less minimal distance to the growth plate (p = 0.02) and more septation chambers in radiologic imaging (p = 0.02). Patients with open revision surgery were less likely to require a second revision due to lesion treatment failure than patients with percutaneous revision surgery (p = 0.03).

Conclusion: Open surgery for UBC can only be recommended as reserve treatment in younger children with actively growing lesions. Open UBC surgery carries a relatively high risk of almost 30% of lesion treatment failure and therefore the indications should be limited to extensive osteolysis with high risk of pathological fractures, lesions with displaced pathological fractures, and lesions with an ambiguous radiological presentation that require tissue collection.

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单孔骨囊肿的开放手术治疗 :回顾性数据分析
背景:单孔骨囊肿(UBC)有多种治疗方案。本研究讨论了开放性治疗 UBC 的争议。本研究旨在分析一家医疗机构在开放手术治疗 UBC 方面的经验:通过对维也纳骨与软组织肿瘤登记处(Vienna Bone and Soft Tissue Tumor Registry)进行回顾性分析,纳入了119例经组织学证实的UBC开放手术患者,平均随访时间为4.8年(1-30年不等)。病变治疗失败的定义是,经手术治疗的UBC因持续存在或复发而接受翻修手术:结果:病灶治疗失败后的局部无翻修生存率在 1 年后为 93%,2 年后为 80%,5 年后为 60%,10 年后为 57%。其中 34 名患者(29%)因病灶治疗失败至少进行过一次翻修手术。我们发现,病灶治疗失败的患者年龄更小(P = 0.03),UBC与生长板的最小距离更小(P = 0.02),放射成像中的隔室更多(P = 0.02)。与接受经皮翻修手术的患者相比,接受开放翻修手术的患者因病变治疗失败而需要二次翻修的可能性较小(p = 0.03):结论:对于年龄较小、病灶生长活跃的儿童,UBC开放手术只能作为后备治疗手段。开放手术治疗 UBC 的风险相对较高,病变治疗失败的风险接近 30%,因此其适应症应仅限于病理骨折风险较高的广泛溶骨、病理骨折移位的病变以及放射学表现不明确、需要采集组织的病变。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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