Aneurysmal bone cysts are associated with a high rate of recurrence. Many aneurysmal bone cysts arise near open physes or
articular cartilage in skeletally immature patients. Fear of damaging these structures could cause surgeons to curette the
tumors less aggressively. We hypothesized location of an aneurysmal bone cyst in a periarticular or juxtaphyseal location
would increase the risk of recurrence. We retrospectively studied 53 patients with aneurysmal bone cysts treated between 1989
and 2004. All patients had primary disease, and all patients underwent curettage of the lesion. Ten patients (18.9%) had local
recurrence. Gender, race, and size did not predict recurrence; however 12 years of age or younger was associated with recurrence.
Of the 19 juxtaphyseal cysts directly adjacent to an open physis, eight developed recurrence. Of the five periarticular cysts,
two developed recurrence. The data suggest the risk of recurrence is highest in pediatric patients with juxtaphyseal or periarticular
aneurysmal bone cysts. Meticulous treatment of these cysts is necessary, but we believe an overly aggressive approach that
destroys the physis or articular cartilage is not warranted. Preservation of these structures remains a high priority of treatment.
Level of Evidence: Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
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patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent was obtained.