Neoplasms

Symptoms and General Pathology

All Conditions

Musculoskeletal Diseases

Cysts

Bone Cysts

Pathological Conditions, Anatomical

Bone Diseases

All Drugs and Chemicals

Bone Density Conservation Agents

Calcium

Calcium, Dietary

Hormones

Curettage with puncture (C \& P) will be performed alone

A predetermined amount of Vitoss morsels will be injected following the curettage and puncture (C \& P)

A curette will be inserted to scrape the contents of the cyst (curettage) and a hole in the cyst wall will be made (puncture) near the bone marrow cavity

Curettage with puncture (C & P)

A small surgical instrument with a rounded edge designed for scraping

Curette

A bone substitute intended for use as a filler for voids or gaps in bones

Vitoss morsels

Project Manager

Elisabeth Clarke

Martin Morrison III

Carly Strohbach

Jamie Burgess

Joseph A Janicki

Julie Titter

Anna Vergun

Grace Anand

Vinitha R Shenava

Melissa Formosa

Brian Loh

Yoga Dhanapala

Elaine Joughin

Harpreet Chhina

Tony Cooper

Kishore Mulpuri

Jennifer Hurry

Karl Logan

Jacob Davidson

Debra Bartley

Holly Livock

Sasha Carsen

Julie Shiu

Sevan Hopyan

Emma Spink

Dan Perry

Kim Gardiner

Andreas Roposch

Imelda Mayor

Mohamed Kenawey

Rebecca Harmer

Tim Theologis

Aimee Corcoran

Nicolas Nicolaou

James G. Wright

Simple bone cysts (SBCs) are cysts filled with fluid that occur most frequently in the long bones (arms or legs) of children. There are many ways to treat SBCs but it is unclear if one is better than another. The purpose of this research trial is to compare the effectiveness of two common treatments that are used by surgeons today.

In general, few randomized clinical trials have been undertaken in paediatric orthopaedics, and only one to date has addressed the problem of simple bone cysts (SBCs). Also known as unicameral bone cysts, they are the commonest bone lesion in children. Despite general opinion, these cysts do not resolve at skeletal maturity.

Many forms of treatment have been recommended but none, including the popular methods of corticosteroid or bone marrow injections, have reliably eradicated SBC. Although the lesions are considered benign (non-cancerous), they cause pain, frequently interfere with function, dramatically restrict play activity, may re-fracture leading to growth arrest and/or deformity, and cause enormous anxiety for children and their families.

With a well-developed network of surgeons and researchers, we will provide evidence comparing the effectiveness of two treatment interventions for SBC. More specifically, our goals for this study are:

1. to compare the rate of radiographic healing between two standard treatments including curettage with puncture alone, and curettage with puncture followed by injection with Vitoss morsels;
2. to identify prognostic radiographic factors associated with simple bone cyst healing and fracture;
3. to determine the impact of simple bone cyst on children/family functioning.

Simple Bone Cysts in Kids

Simple Bone Cysts in Kids (SBoCK)

Healing will be graded according to a 4-point modified Neer's classification by radiologists

Cyst features (ie. appearance, size) will be described or measured from X-rays taken annually after treatment

Function in participants will be evaluated using self-reported questionnaires for activity level, perception of illness, and pain annually after treatment

Canadian Institutes of Health Research (CIHR)

The Hospital for Sick Children

Orthopaedic Surgeon

Spots Global Cancer Trial Database for curettage with puncture (c & p)