Abstract
BACKGROUND: This study aims to analyze long-term outcomes in patients with aneurysmal bone cysts (ABCs) and demonstrate effective disease control. In the literature, the absence of a long-term study systematically evaluating the outcomes of a population with such a significant number of patients from different age groups will shed light on our surgical preferences. METHODS: The study encompassed ABC diagnoses, primarily concerning long bones (46 women, 62 men; mean age 19.4 years; range 2-67) extracted from patient records spanning from 2007 to 2022 in our clinic. The average follow-up was 81 months. Extended intralesional curettage was performed using a mechanical burr, cauterization, grafting and internal fixation in 96 patients (88.9%), whereas resection was carried out in 12 patients (11.1%). RESULTS: Pathological fractures occurred in 35% of cases. Reconstruction was performed in five patients (4.6%; endoprosthetic in 4, biological reconstruction in 1) and seven patients (6.5%) required no reconstruction. The mean Musculoskeletal Tumor Society (MSTS) score was 95.5 (range 60-100). Complications and recurrence rates were 12% and 9.3%, respectively. Surgical choice and adjuvant agent significantly influenced long-term complications and recurrence (p = 0.001). CONCLUSIONS: In the treatment management of aneurysmal bone cysts, extended intralesional curettage surgery coupled with the use of electrocautery and a high-speed burr has shown successful outcomes in long-term follow-up. A wider sample size with prospective randomized studies can be conducted regarding the treatment of ABCs.