Use of Liquid Nitrogen as A local Adjuvant to Decrease Recurrence after Extended Curettage, and Reconstruction by Autogenous Bone Graft for Treatment of Aneurysmal bone Cyst: Our Updated Experience

Background: Aneurysmal bone cyst [ABC] can be managed by curettage and different bone grafts. However, the recurrence rate is high, and different adjuvants had been proposed to reduce recurrence. The use of liquid nitrogen could be used as an adjuvant. Aim of the work: To present our experience with liquid nitrogen use as an adjuvant in ABC's management. Patients and Methods: Twenty-five patients with ABC had been evaluated. All were treated by extended curettage followed by liquid nitrogen for two cycles and reconstruction of the cavity by a bone graft. Radiological and functional outcomes had been documented, and any complications had been registered. Results: Femur was the most common site for ABC. The graft was obtained from iliac crest for all patients, mainly corticocancellous [68.0%]. The ABC grade was grade 2 among [80.0%] and grade 3 among [20.0%]. Graft union achieved in all patients in an average of 6.52±2.27 months. The mean follow-up duration was [44.52±16.81 months; range 24- 72 months], and all patients were alive and completely free from the disease. The functional score ranged from 70% to 94%, [average of 85.12±7.32%]. Recurrence rate [8.0%] and wound infection had been recorded in another two patients [treated conservatively and completely resolved within days]. Conclusion: Extended curettage of ABC with adjuvant cryotherapy had good results with a lower recurrence rate. The additional use of a bone graft allowed for consolidation in all cases with a short time for cyst healing.