Minimally invasive endoscopic treatment for unicameral bone cysts: technique and outcomes in a series of 33 pediatric and adolescent patients.
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OBJECTIVE: To evaluate the clinical efficacy and safety of a minimally invasive endoscopic protocol-combining curettage, sclerotherapy, and injectable bone grafting-in the treatment of unicameral bone cysts (UBCs). METHODS: From March 2019 to August 2024, 33 pediatric and adolescent patients with UBCs were treated using a standardized minimally invasive endoscopic curettage combined with sclerotherapy and injectable bone grafting at our institution. The cohort included 24 males and 9 females, with a mean age of 10.1 years (range 4-20 years). Patients were followed for an average of 48.4 months (range 12-76 months). Radiographic healing rates, functional score, and complications were assessed. RESULTS: According to the modified Neer classification, complete or partial radiographic healing was achieved in 30 cases (90.9%), while 3 cases experienced persistent or recurrent cyst (9.1%). Almost all patients recovered excellent function. No postoperative pathological fractures or growth plate disturbances were observed during a mean follow-up of 48.4 months. Complications were limited to one episode of transient pain and one case of mild swelling, both self-limiting without intervention. Postoperative hospitalization was brief (mean, 1.2 days), and cosmetic outcomes were excellent, with minimal portal scars, far less conspicuous than those from traditional open procedures. CONCLUSION: Endoscopic minimally invasive surgery combining curettage, sclerotherapy, and injectable bone grafting appears to be a safe and effective option for the management of UBCs in children and adolescents, achieving high healing rates and low complication risks. Nevertheless, given the single-arm design and limited sample size, larger controlled studies with long-term follow-up are needed to confirm these findings.