Abstract
Two cases of induced healing of aneurysmal bone cyst (ABC) following intralesional implantation of a bone paste made of autogeneic bone marrow and allogeneic bone powder are reported. The calcaneum in one case and the superior pubic ramus in the other were blown out by an ABC and would have required extensive surgery. Via a minimal exposure, the cyst was partially evacuated and filled with an admixture of a partially demineralized bone particles with bone marrow. Ossification of the peripheral shell was the first sign of healing and was observed within the first 3 postoperative months. Successful healing was observed in both cases. The rationale underlying this intralesional treatment was that the bone grafting material might reverse ABC expansion by promoting ossification through a bone induction mechanism. The concept of this treatment was to retain the ABC tissue, using its own intrinsic osteogenic potential to promote healing. By triggering intralesional new bone formation, the bone paste represented an effective means to reverse the expanding phase of ABC. The particulated bone allograft was easy to handle and to introduced in an irregular cavity. Moreover, as a complete cyst evacuation was not required, a minimal surgical approach could be used so that the risks and morbidity associated with an extensive approach were reduced. Its use is of particular interest in poorly accessible areas like the pelvis and spine.
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References
American Association of Tissue Banks (1987) Standards for surgical bone banking. AATB, Arlington
Ashton BA, Allen TD, Howlett CR, Eaglesom CC, Hattori A, Owen M (1980) Formation of bone and cartilage by marrow stromal cells in diffusion chambers in vivo. Clin Orthop 151:294–301
Aspenberg P, Lohmander LS, Thorngren KG (1988) Failure of bone induction by bone matrix in adult monkeys. J Bone Joint Surg [Br] 70:625–627
Biesecker JL, Marcove RC, Huvos AG, Mike V (1970) Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer 26:615–625
Campanacci M, Capanna R, Picci P (1986) Unicameral and aneurysmal bone cysts. Clin Orthop 204:25–36
Campanacci M (1990) Aneurysmal bone cyst. In: Campanacci M (ed) Bone and soft tissue tumors. Springer, Berlin Heidelberg New York, pp 725–751
Celeste AJ, Iannazzi JA, Taylor RC, Hewick RM, Rosen V, Wang E, Wozney JM (1990) Identification of transforming growth factor β family members present in bone-inductive protein purified from bovine bone. Proc Natl Acad Sci USA 87:9843–9847
Cook SD, Baffes GC, Wolfe MW, Sampath TK, Rueger DC, Whitecloud III TC (1994) The effect of recombinant human osteogenic protein-1 on healing of large segmental bone defects. J Bone Joint Surg [Am] 76:827–838
Cottalorda J, Bollini G, Panuel M, Scheiner C, Jouve JL, Labriet C, Bouyala JM (1993) Le kyste anéurysmal des os chez l'enfant. Rev Chir Orthop 79:272–280
Dabezies EJ, D'Ambrosia RD, Chuinard RG, Ferguson AB (1982) Aneurysmal bone cyst after fracture: a report of three cases. J Bone Joint Surg [Am] 64:617–621
Dabska M, Buraczewski J (1969) Aneurysmal bone cyst: pathology, clinical course and radiologic appearances. Cancer 23:371–389
DeCristofaro R, Biagini R, Boriani S, Picci P, Rugieri P, Rossi G, Fabbri N, Roversi R (1992) Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone. Skeletal Radiol 21:523–527
Delloye C (1990) The bridging capacity of a cortical bone defect by different bone grafting materials and diaphyseal distraction lengthening. Thesis, Catholic University of Louvain
Delloye C (1993) Current situation and future of tissue banking in orthopaedics. In: Duparc J (ed) Post graduate lectures of European Federation of National Association of Orthopaedics and Traumatology (EFORT). Masson, Paris, pp 161–172
Einhorn TA, Lane JM, Burstein AH, Kopman CR, Vigorita VJ (1984) The healing of segmental bone defects induced by demineralized bone matrix. A radiographic and biomechanical study. J Bone Joint Surg [Am] 66:274–279
European Association of Musculoskeletal Transplantation (1994) Standards for tissue banking and current developments. EAMST, Brussels
Farsetti P, Tudisco C, Pentimalli G, Ippolito E (1990) Aneurysmal bone cyst. Long-term follow-up of 20 cases. Arch Orthop Trauma Surg 109:221–223
Johnson EE, Urist MR, Schmalzried TP, Chotivichit A, Huang HK, Finerman GA (1989) Autogeneic cancellous bone grafts in extensive segmental ulnar defects in dogs. Clin Orthop 243:254–265
Lindholm TS, Nilsson OE, Lindholm TC (1982) Extraskeletal and intraskeletal new bone formation induced by demineralized bone matrix combined with bone marrow cells. Clin Orthop 171:251–255
Malghem J, Maldague B, Esselinckx W, Noel H, De Nayer P, Vincent A (1989) Spontaneous healing of aneurysmal bone cysts. A report of three cases. J Bone Joint Surg [Br] 71:645–650
Mirra J (1989) Aneurysmal bone cyt. In: Mina J (ed) Bone tumors. Lea & Febiger, Philadelphia, pp 1267–1311
Murphy WA, Strecker WB, Schoenecker PL (1982) Trans-catheter embolisation therapy of an ischial aneurysmal bone. J Bone Joint Surg [Br] 64:166–168
Reddi AH, Wientroub S, Muthukumaran M (1987) Biologic principles of bone induction. Orthop Clin N Am 18:207–212
Schwarz N, Schlag G, Thumher M, Eschberger J, Dinges HP, Redi H (1991) Fresh autogeneic, frozen allogeneic and decalcified allogeneic bone grafts in dogs. J Bone Joint Surg [Br] 73:787–790
Scott I, Connell DG, Duncan CP (1986) Regression of aneurysmal bone cyst following open biopsy. J Can Assoc Radiol 37:198–200
Takagi K, Urist MR (1982) The role of bone marrow in bone morphogenetic protein-induced repair of femoral massive diaphyseal defects. Clin Orthop 171:224–231
Urist MR (1965) Bone: formation by autoinduction. Science 150:893–899
Vandersteenhoven JJ, Spector M (1983) Histological investigation of bone induction by demineralized allogeneic bone matrix: a natural biomaterial for osseous reconstruction. J Biomed Mater Res 17:1003–1014
Wilner D (1982) Radiology of bone tumors and allied disorders. Saunders, Philadelphia, pp 1003–1103
Wittbjer J, Palmer B, Rohlin M, Thorngren KG (1983) Osteogenetic activity in composite grafts of demineralized compact bone and marrow. Clin Orthop 173:229–238
Wozney JM, Rosen V, Celeste AJ, Mitsock LM, Whitters MJ, Kriz RW, Hewick RM, Wang EA (1988) Novel regulators of bone formation: molecular clones and activities. Science 242:1528–1534
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Delloye, C., De Nayer, P., Malghem, J. et al. Induced healing of aneurysmal bone cysts by demineralized bone particles. Arch Orthop Trauma Surg 115, 141–145 (1996). https://doi.org/10.1007/BF00434541
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DOI: https://doi.org/10.1007/BF00434541