A study of 23 unicameral bone cysts of the calcaneus: open chip allogeneic bone graft versus percutaneous injection of bone powder with autogenous bone marrow.
BACKGROUND
The treatment of unicameral bone cyst varies from percutaneous needle biopsy, aspiration and local injection of steroid, autologous bone marrow, or demineralized bone matrix to curettage and open bone-grafting. The purpose of this study was to compare the results of open chip allogeneic bone graft versus percutaneous injection of demineralized bone powder with autogenous bone marrow in management of calcaneal cysts.


METHODS
Twenty-three calcaneal unicameral cysts in 20 patients were treated. Lyophilized irradiated chip allogeneic bone (CAB) and autogenous bone marrow were used for treatment of 13 cysts in 11 patients, and 10 cysts in 9 patients were treated with percutaneous injection of irradiated allogeneic demineralized bone powder (DBP) and autogenous bone marrow. There were 11 males and 9 female patients with mean age of 17 years.


RESULTS
The patients were followed for an average of 49.4 months. Complete healing was achieved in 9 cysts treated with chip allogeneic bone and in 5 cysts treated with powdered bone. Four cysts treated with CAB and 3 cysts treated with DBP healed with a defect. Two cysts treated with powdered bone and autogenous bone marrow were classified as persistent. No infections or pathological fractures were observed during the followup period.


CONCLUSIONS
Percutaneous injection of a mixture of allogeneic bone powder with autogenous bone marrow is a minimal invasive method and could be an effective alternative in the treatment of unicameral calcaneal bone cysts. The postoperative morbidity was low, the hospital stay was brief, and patient's comfort for unrestricted activity was enhanced.
Park
Il-Hyung
IH
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
Micic
Ivan Dragoljub
ID
Jeon
In-Ho
IH
D000293:Adolescent; D000328:Adult; D001845:Bone Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D016026:Bone Marrow Transplantation / Q000379:methods*; D001857:Bone Matrix / Q000637:transplantation*; D016025:Bone Transplantation / Q000379:methods*; D002111:Calcaneus; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D011859:Radiography; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome