Polidocanol sclerotherapy for the treatment of aneurysmal bone cyst, with or without pathological fractures: A prospective, comparative study

Sohail Ahmad; Intekhab Alam; Abdul Qayyum Khan; Mohammad Baqar Abbas; Madhav Chowdhry

doi:10.1016/j.jor.2023.10.022

Polidocanol sclerotherapy for the treatment of aneurysmal bone cyst, with or without pathological fractures: A prospective, comparative study

J Orthop. 2023 Nov 3:46:143-149. doi: 10.1016/j.jor.2023.10.022. eCollection 2023 Dec.

Authors

Sohail Ahmad¹, Intekhab Alam¹, Abdul Qayyum Khan¹, Mohammad Baqar Abbas¹, Madhav Chowdhry¹

Affiliation

¹ Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, 202001, Uttar Pradesh, India.

PMID: 38009081
PMCID: PMC10665595 (available on 2024-12-01)
DOI: 10.1016/j.jor.2023.10.022

Abstract

Introduction: Polidocanol sclerotherapy in the treatment of aneurysmal bone cysts (ABCs) with or without pathological fractures has been a topic of debate. While some studies recommend intralesional curettage as the preferred treatment, others suggest intralesional sclerosants as an effective alternative.

Material and methods: This study evaluates the use of polidocanol-based percutaneous sclerosant therapy in 28 patients with ABCs, of which 8 patients had pathological fracture. The patients received injections every four weeks based on clinical and radiological evaluation of the cyst, and the study assessed the results and complications of the treatment.

Results: In group A (without pathological fractures), 14 out of 17 (82.4 %) lesions healed without any significant residual lesion. Three out of 17 (17.6 %) patients required further surgical intervention and were treated by curettage and bone grafting, definitively. Minor local inflammatory reaction was observed in 3 patients, which resolved without intervention within 3-4 days. In group B, all the 8 patients (100 %) with pathological fracture in their lesions healed as Grade 1 healing, without any significant residual lesion. One patient developed an episode of anesthesia related complication (delayed recovery) which resolved within an hour, without any residual effect. At final follow up, no recurrence was seen in any patient.

Conclusion: The study concludes that polidocanol sclerotherapy is an effective treatment option for patients with ABCs, with or without pathological fractures, and has the potential to become the new treatment of choice for pathological fractures due to its low invasiveness, low morbidity, and affordability. However, further research is needed to confirm the efficacy of polidocanol sclerotherapy in larger patient populations and to compare its effectiveness with other treatment options.

Keywords: Aneurysmal bone cyst; Cyst; Polidocanol; Sclerotherapy; Tumor.