Doxycycline Sclerotherapy of Aneurysmal and Unicameral Bone Cysts in the Appendicular Skeleton and Pelvis: Single-Center 14-Year Experience.

PURPOSE

To evaluate the safety, effectiveness, and patient satisfaction of doxycycline sclerotherapy for aneurysmal bone cysts (ABCs) and unicameral bone cysts (UBCs).

MATERIALS AND METHODS

This was an institutional review board (IRB)-approved single-center retrospective review of all ABCs and UBCs of the appendicular skeleton and pelvis completing doxycycline sclerotherapy and having at least 2 years of follow-up from 2007 to 2021. Radiographic outcomes in a patient cohort were assessed with a modified Neer score. Patient-reported outcome (PRO) surveys were completed by a subgroup of the cohort assessing pain after treatment (Likert scale), functional outcomes (Patient-Reported Outcomes Measurement Information System), and overall patient satisfaction (adapted from the Musculoskeletal Tumor Society).

RESULTS

Seventy-seven lesions met the inclusion criteria, with 55 (71%) receiving bone void filler in addition to doxycycline. Of the 77 lesions, 76 (99%) were successfully treated. Twelve lesions (16%) recurred but resolved with additional doxycycline treatment. One lesion failed sclerotherapy, requiring surgical excision. Of the 383 total treatments performed, 17 resulted in Society of Interventional Radiology (SIR)-classified adverse events (9 with Grade 1, 7 with Grade 2, and 1 with Grade 3). Twenty-five (32%) of the 77 cases completed PRO surveys, with 20 (80%) having little to no pain and 15 (60%) having no functional impairment after completing treatment. The PRO surveys documented high levels of satisfaction, with all patients agreeing that they would undergo doxycycline sclerotherapy again if given the option.

CONCLUSIONS

Doxycycline sclerotherapy (with or without bone void filler) is a safe, effective, and well-tolerated stand-alone treatment for ABCs and UBCs.