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Unicameral Bone Cysts: Review of Etiopathogenesis and Current Concepts in Diagnosis and Management

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Abstract

Objective

This article aims to review the epidemiology, etio-pathogenesis and updates in clinical diagnostics and management of unicameral bone cysts (UBC).

Methods

A computerized literature search using Cochrane database of systematic reviews, EMBASE and PubMed was performed. MeSH (Medical Subject Headings) terms used in searches included the following sub-headings: “unicameral bone cyst”, “epidemiology”, “etiology”, “pathogenesis”, “diagnosis”, “management” and “surgery”. Studies were analyzed based on clinical relevance for the practicing orthopedic surgeon.

Results

UBC accounts for 3% of all bone tumors and is asymptomatic in most cases. Nearly 85% of cases occur in children and adolescents, with more than 90% involving the proximal humerus and proximal femur. Despite multiple theories proposed, the exact etiology is still unclear. Diagnosis is straightforward, with radiographs and MRI aiding in it. While non-surgical treatment is recommended in most cases, in those warranting surgery, combined minimal-invasive techniques involving decompression of cyst and stabilization have gained importance in recent times.

Conclusion

There is variation in the diagnosis and treatment of UBCs among surgeons. Due to the vast heterogeneity of reported studies, no one method is the ideal standard of care. As most UBCs tend to resolve by skeletal maturity, clinicians need to balance the likelihood of successful treatment with morbidity associated with procedures and the risks of developing a pathological fracture.

Study Design

Review Article.

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Abbreviations

UBC:

Unicameral bone cyst

BM:

Autologous bone marrow

DBM:

Demineralized bone matrix

IM:

Intramedullary

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Authors and Affiliations

  1. Clinical Fellow, Musculoskeletal Oncology, Royal Orthopaedic Hospital, Birmingham, UK

    Raja Bhaskara Rajasekaran

  2. Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt. Ltd, 313, Mettupalayam Road, Coimbatore, India

    Venkatadass Krishnamoorthy

  3. Bone and Soft Tissue Sarcoma Service, Tata Memorial Hospital, Mumbai, India

    Ashish Gulia

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  1. Raja Bhaskara Rajasekaran
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  3. Ashish Gulia
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RBR conception of the study, analysis of articles, review of articles, writing of manuscript. VK reviewed the manuscript, suggested corrections in manuscript. AG conception of the study, reviewed the manuscript.

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Correspondence to Raja Bhaskara Rajasekaran.

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Rajasekaran, R., Krishnamoorthy, V. & Gulia, A. Unicameral Bone Cysts: Review of Etiopathogenesis and Current Concepts in Diagnosis and Management. JOIO 56, 741–751 (2022). https://doi.org/10.1007/s43465-022-00607-6

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