Sclerotherapy injection in management of aneurysmal bone cyst

Background and aim Aneurysmal bone cyst (ABC) is a benign bone lesion of childhood and adolescence. It can be locally aggressive, with risk of fracture. Management is controversial. The study aimed to assess radiologically the healing of ABC together with assessment of Patient’s functional and physiological activities in response to Polidocanol with adjuvant bone marrow injection. Patients and methods This prospective case–series study was conducted on 20 patients with ABCs of long bones (femur, tibia, and humerus) that were managed by sclerotherapy (polidocanol) injection at Al-Azhar University Hospitals, Department of Orthopedics and Trauma Surgery, between 2022 and 2023. Results The mean initial visual analogue scale (VAS) for pain was 6.2±1.3. Before the fourth injection, the mean VAS declined to 1.9±1.4. The pain level continued to decline from 1 to 12 months after the fourth injection. At 12 months following the fourth injection, the mean VAS for pain was 0.3±0.48. Regarding postoperative complications, one patient developed nausea and vomiting, and two patients reported ecchymosis at the injection site. Conclusion We assessed the radiological healing of ABC in response to Polidocanol injection, together with an assessment of functional and physiological activities. Percutaneous intervention is the treatment of choice now in the management of ABC as it is effective, less invasive, and more cosmetically with no donor site morbidity as in conventional open intervention.