Unicameral bone cysts: general characteristics and management controversies

J Am Acad Orthop Surg. 2014 May;22(5):295-303. doi: 10.5435/JAAOS-22-05-295.

Abstract

Unicameral bone cysts are benign bone lesions that are often asymptomatic and commonly develop in the proximal humerus and femur of skeletally immature patients. The etiology of these lesions remains unknown. Most patients present with a pathologic fracture, but these cysts can be discovered incidentally, as well. Radiographically, a unicameral bone cyst appears as a radiolucent lesion with cortical thinning and is centrally located within the metaphysis. Although diagnosis is frequently straightforward, management remains controversial. Because the results of various management methods are heterogeneous, no single method has emerged as the standard of care. New minimally invasive techniques involve cyst decompression with bone grafting and instrumentation. These techniques have yielded promising results, with low rates of complications and recurrence reported; however, prospective clinical trials are needed to compare these techniques with current evidence-based treatments.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Bone Cysts / diagnosis*
  • Bone Cysts / etiology
  • Bone Cysts / therapy*
  • Bone Marrow Transplantation
  • Bone Transplantation
  • Decompression, Surgical
  • Diagnosis, Differential
  • Femoral Neck Fractures / surgery*
  • Fracture Fixation, Internal
  • Fractures, Spontaneous / etiology*
  • Humans

Substances

  • Adrenal Cortex Hormones