Symptomatic Solitary Bone Cyst of the Lower Extremity with Load-Dependent Pain — Without Pathological Fracture

This protocol addresses patients with a symptomatic solitary bone cyst (SBC) in the lower extremity who experience pain specifically during weight bearing, but have not yet developed a pathological fracture.

Clinical Scenario Unlike cysts of the upper limb, lower-extremity SBCs impose mechanical loading that generates pain and raises the risk of fracture. Surgical stabilisation can be warranted even in the absence of an established fracture, given the demands placed on the weight-bearing limb.

Approach (partial overview) An intralesional surgical intervention with structural reconstruction of the resulting bone defect is employed in this setting. The full evidence-based regimen — including the complete sequence and decision criteria — is available via the link below.

Treatment Goals Resolution of load-dependent bone pain and complete healing of the cyst as confirmed on radiograph.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jbo.2021.100384

Contrary to the upper limb surgical stabilization can also be considered in symptomatic unfractured SBCs of the lower extremity due to load-dependent pain and increased risk of fracture.

Curettage and defect reconstruction with bone substitute in cases without pathological fracture are performed due to pain under weight bearing in the lower extremity.

In these conditions intralesional curettage and defect reconstruction with bone substitute might be preferable.

After intralesional curettage and defect reconstruction with bone substitute complete healing of the cyst can be observed in one-third of the cases.

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