A randomized clinical trial comparing intralesional bone marrow and steroid injections for simple bone cysts

被引:107
作者
Wright, James G.
Yandow, Suzanne
Donaldson, Sandra
Marley, Lisa
机构
[1] Department of Surgery, Hospital for Sick Children, Toronto, ON M5G 1X8
[2] Central Texas Pediatric Orthopedics, Austin, TX 78723
[3] Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, ON M5G 1X8
[4] Shriners Hospital for Children, Intermountain, Salt Lake City, UT 84103, Fairfax Road at Virginia Street
关键词
D O I
10.2106/JBJS.G.00620
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Simple bone cysts are common benign lesions in growing children that predispose them to fracture and are sometimes painful. The purpose of this trial was to compare rates of healing of simple bone cysts treated with intralesional injections of bone marrow with rates of healing of those treated with methylprednisolone acetate. Methods: Of ninety patients randomly allocated to treatment with either a bone-marrow or a methylprednisolone acetate injection, seventy-seven were followed for two years. The primary outcome, determined by a radiologist who was blind to the type of treatment, was radiographic evidence of healing. The cyst was judged to be either not healed (grade 1 [a clearly visible cyst] or grade 2 [a cyst that was visible but multilocular and opaque]) or healed (grade 3 [sclerosis around or within a partially visible cyst] or grade 4 [complete healing with obliteration of the cyst]). Patient function was assessed with use of the Activity Scale for Kids, and pain was assessed with the Oucher Scale. Results: Sixteen (42%) of the thirty-eight cysts treated with methylprednisolone acetate healed, and nine (23%) of the thirty-nine cysts treated with bone marrow healed (p = 0.01). There was no significant difference between the treatment groups (p > 0.09) with respect to function, pain, number of injections, additional fractures, or complications. Conclusions: Although the rate of healing of simple bone cysts was low following injection of either bone marrow or methylprednisolone, the latter provided superior healing rates. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
引用
收藏
页码:722 / 730
页数:9
相关论文
共 38 条
  • [1] [Anonymous], CHILDRENS HEATH CARE
  • [2] BATINIC D, 1990, BONE MARROW TRANSPL, V6, P103
  • [3] Beyer J E, 1992, J Pediatr Nurs, V7, P335
  • [4] CAMPANACCI M, 1986, CLIN ORTHOP RELAT R, P25
  • [5] CAPANNA R, 1982, CLIN ORTHOP RELAT R, P204
  • [6] Unicameral bone cysts treated by injection of bone marrow or methylprednisolone
    Chang, CH
    Stanton, RP
    Glutting, J
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2002, 84B (03): : 407 - 412
  • [7] THE ETIOLOGY AND TREATMENT OF SIMPLE BONE-CYSTS
    CHIGIRA, M
    MAEHARA, S
    ARITA, S
    UDAGAWA, E
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1983, 65 (05): : 633 - 637
  • [8] DEVELOPMENT OF AN OSTEOGENIC BONE-MARROW PREPARATION
    CONNOLLY, J
    GUSE, R
    LIPPIELLO, L
    DEHNE, R
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1989, 71A (05) : 684 - 691
  • [9] Benign calcaneal bone cyst and pathologic fracture -: Surgical treatment with injectable calcium-phosphate bone cement (Norian®):: A case report
    Csizy, M
    Buckley, RE
    Fennell, C
    [J]. FOOT & ANKLE INTERNATIONAL, 2001, 22 (06) : 507 - 510
  • [10] Simple bone cysts treated with aspiration and a single bone marrow injection - A preliminary report
    Delloye, C
    Docquier, PL
    Cornu, O
    Poilvache, P
    Peters, M
    Woitrin, B
    Rombouts, JJ
    De Nayer, P
    [J]. INTERNATIONAL ORTHOPAEDICS, 1998, 22 (02) : 134 - 138