Bone Graft Vs Bone Substitutes in Treatment of Cystic Benign Bone Tumors

Background: Cystic benign bone tumors are common lesions in children and young adults, frequently affecting the metaphyseal regions of long bones. Surgical curettage is the standard treatment, but the resulting defect requires filling. Both bone grafts (autograft/allograft) and synthetic bone substitutes are widely used, yet the optimal choice remains debated. Therefore, when it was feasible, we sought to compare the radiological and clinical results following the surgical treatment of cavitary benign bone tumors utilizing bone grafts or synthetic bone replacements. Methods: This prospective study was conducted at the Orthopedic Surgery Department, Zagazig University Hospitals on Eighteen patients with cystic benign bone tumors who were divided into: Group I underwent curettage and bone grafting, while Group II received curettage and synthetic bone substitutes. Patients were evaluated clinically and radiologically postoperatively. Results: Both groups achieved high healing rates. In Group I, 88.9% achieved complete healing (Neer score I), and 11.1% healed with residual defects. In Group II, 88.9% achieved complete healing, while 11.1% showed persistent cysts. Recurrence occurred in 1 case (11.1%) in each group. Surgical site infection was observed in 33.3% of Group II but in none of Group I. The mean MSTS score showed no significant difference between the two groups. However, recurrent cases had significantly lower MSTS scores. Conclusion: Both bone grafts and bone substitutes are effective in treating cystic benign bone tumors, achieving comparable healing and functional outcomes. However, autogenous bone grafting showed lower infection rates, while synthetic substitutes provided easier availability and avoided donor site morbidity.