title: Recent developments in treatment for simple bone cysts.
abstract: OBJECTIVE
  The purpose of this paper is to review treatment strategies for simple bone cysts (SBCs).
  
  
  RESULTS
  Recent studies have focused on disrupting the wall of the cyst in combination with injectable bone substitutes. Bone substitutes are minimally invasive, provide an osteoconductive scaffold, and are relatively easy to use. Many of these studies, however, have methodological issues (uncontrolled, not randomized, unblinded outcome assessment, or short-term follow-up) and inconsistent radiographic outcomes making it difficult to determine the benefits of these newer treatment strategies.
  
  
  CONCLUSIONS
  Based on a single randomized clinical trial, steroids are the only evidence-based treatment for SBCs. Further basic science is needed to understand the pathoetiology and to develop future biologic solutions. Multimodal treatment strategies with opening of the medullary canal and disruption of the cyst wall, filling defect with a bone substitute, and possible biologic treatment of the cyst membrane may be the best strategy. When considering cysts of the lower extremity, structural support may be required in addition to treatment of the cyst.
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada. sandra.donaldson@sickkids.ca
authors.forename: Sandra
authors.initials: S
authors.lastname: Donaldson
authors.forename: James G
authors.initials: JG
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D001845:Bone Cysts / Q000188:drug therapy / Q000628:therapy*; D016026:Bone Marrow Transplantation; D018786:Bone Substitutes / Q000627:therapeutic use*; D002133:Calcium Sulfate / Q000627:therapeutic use*; D002648:Child; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D016032:Randomized Controlled Trials as Topic
chemical_list: D018786:Bone Substitutes; D005938:Glucocorticoids; D002133:Calcium Sulfate