Bone cyst curettage and grafting is an operation to scrape out a benign bone cyst or tumour and fill the cavity with bone graft. It is performed for symptomatic benign bone lesions such as unicameral bone cysts, aneurysmal bone cysts, and giant cell tumours.
An incision is made over the affected bone. A window is created in the bone cortex. The cyst lining is thoroughly scraped out (curettage) using special curettes. The cavity may be treated with phenol, hydrogen peroxide, or liquid nitrogen to reduce recurrence. The cavity is then filled with bone graft (autograft, allograft, or synthetic substitute). The bone window is closed or covered with a plate. The operation takes one to two hours.
Surgery is recommended when a bone cyst causes pain, fracture risk, or has already caused a pathological fracture. It is also performed when the diagnosis needs to be confirmed with tissue analysis.
Small, asymptomatic cysts may be observed with periodic imaging. Corticosteroid injection into some bone cysts (particularly unicameral bone cysts in children) may promote healing. Pathological fractures through bone cysts sometimes heal and allow the cyst to resolve.
MRI and CT for characterisation and planning. Biopsy may have been performed first.
Resolution of the cyst, reduction of fracture risk, and pain relief. Healing rates depend on the type of lesion and completeness of curettage.
Benign bone tumours may recur despite thorough curettage. Recurrence rates vary: 10–30% for aneurysmal bone cysts, 15–25% for giant cell tumours.
Expected at the surgical site.
If autograft bone was harvested (usually from the pelvis), the donor site may be sore.
The bone may be weakened during or after surgery. Weight-bearing restrictions reduce this risk.
Wound or bone infection.
Depending on the location of the cyst.
If the cyst is near a joint surface.
General or regional anaesthesia.
Weight-bearing restrictions may apply for four to eight weeks depending on the bone involved and the size of the defect. Physiotherapy to restore movement and strength. Return to activity is guided by X-ray evidence of graft incorporation.
Histology results at two weeks. Regular X-rays to monitor graft incorporation and check for recurrence. Long-term follow-up for two to five years.
There is a risk of recurrence depending on the type of lesion. Regular follow-up imaging is performed to detect recurrence early.
Bone graft (from the patient, a donor, or synthetic material) fills the cavity. Over time, the graft incorporates and is replaced by normal bone.