Aneurysmal bone cyst in the proximal femur: Combined approach of management: a case report

Abstract

Purpose of Study: To study the effectiveness of combined extended curettage and sclerosant therapy in the management of aneurysmal bone cyst of proximal femur. Materials and Methods: A 22 years old male presented with complaints of left hip pain since 20 days, was examined clinically and radiologically. On MRI, he was diagnosed to have a non-expansile lytic lesion in the left proximal femur with features suggestive of aneurysmal bone cyst or an unicameral bone cyst. Patient was planned and taken up for aspiration and curettage followed by a single sitting sclerosant therapy with 3% polidocanol, bone cementing combined with plating. Curetted sample was sent for histo-pathological examination. Patient was advised restricted weight bearing for a period of 4 weeks. Regular follow-ups of the patient was done at 1, 3, 12 and 18 months post-operatively to assess for recurrence. Results: Histo-pathological examination confirmed the diagnosis of aneurysmal bone cyst. With regular follow-ups, patient had a good functional outcome and no evidence of recurrence with this technique at 18 months follow-up. Conclusion: Aneurysmal bone cyst has a higher recurrence rate with curettage and bone grafting alone. Extended curettage along with sclerotherapy with 3% polidocanol has shown no evidence of recurrence at 18 months follow-up in our study. Hence, this combined approach can be recommended in the management of aneurysmal bone cyst.