Author/Authors :
Bragança dos reis oliveira, Marcelo instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, Brazil , Meohas, Walter instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, Brazil , riBeiro silva, ronan Escola de Saúde do Exército, Rio de Janeiro, Brazil , soBral de carvalho, gustavo Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil , carvalho de Queiroz Mello, Fernanda Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil , eduardo Machado Paschoal, Marcos Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Abstract :
Objective: To introduce the intralesional calcitonin and methylprednis-
olone percutaneous injection method, which results in the promotion
of primary aneurysmal bone cyst (ABC) healing. Methods: A retro-
spective cohort study involving 76 patients diagnosed with ABC was
performed between 2005 and 2014. Patients treated with calcitonin
and methylprednisolone injection and who underwent more than 2
years of follow-up were considered eligible for the study (n=47). The
Enneking staging and Capanna classification systems were used
during the initial evaluation. Treatment response was assessed by
Rastogi radiographic grading based on the degree of healing. X2 and
Wilcoxon signed-rank tests and odds ratio calculations were used
in the statistical analysis with a 5% significance level. Results: The
proximal tibia extremity was the most commonly affected site (17.0%).
Thirty-three (70.3%) ABC cases were staged as B3 and 28 (59.7%)
were classified as type II. The average number of injections performed
was 2.8 per patient, with an average reduction of the initial lytic area
of 83.7% (p-value=0.00001). Satisfactory results for 91.4% (n=43;
p-value=0.00001) were obtained and 5 recurrences occurred. No
side effects were observed. Conclusion: Intralesional calcitonin and
methylprednisolone percutaneous injection is a minimally invasive,
effective, and safe method for promoting primary ABC healing. Level
of evidence IV, Type of study: case series.
