Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report
Introduction: The approach to the management of aneurysmal bone cysts has evolved over time, with the focus shifting from surgery to less invasive therapeutic modalities. Curettage with or without bone grafting was considered the procedure of choice until recently but is associated with high recurre...
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| Format: | Article |
| Language: | English |
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Indian Orthopaedic Research Group
2025-07-01
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| Series: | Journal of Orthopaedic Case Reports |
| Subjects: | |
| Online Access: | https://jocr.co.in/wp/2025/07/01/twenty-four-year-follow-up-of-successful-total-hip-arthroplasty-for-recurrent-proximal-femoral-aneurysmal-bone-cyst-with-a-pathologic-fracture-following-extended-curettage-and-bone-grafting-a-case-re/ |
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| author | Javahir A Pachore Vikram I Shah H R Jhunjhunwalla Clint Babu Apurve Parameswaran Krishna Kiran Eachempati |
| author_facet | Javahir A Pachore Vikram I Shah H R Jhunjhunwalla Clint Babu Apurve Parameswaran Krishna Kiran Eachempati |
| author_sort | Javahir A Pachore |
| collection | DOAJ |
| description | Introduction:
The approach to the management of aneurysmal bone cysts has evolved over time, with the focus shifting from surgery to less invasive therapeutic modalities. Curettage with or without bone grafting was considered the procedure of choice until recently but is associated with high recurrence rates. The management of recurrent aneurysmal bone cysts is challenging, especially in the presence of pathologic fractures. Scant literature is available on total hip arthroplasty for aneurysmal bone cysts of the proximal femur.
Case Report:
A 27-year-old man underwent extended curettage and bone grafting for an aneurysmal bone cyst of the right proximal femur in 1999. He presented to the emergency department 17 months after the surgery with a recurrence of the aneurysmal bone cyst and a pathologic fracture of the right femoral neck. He underwent cementless total hip arthroplasty with a ceramic-on-ceramic articulation. Intraoperatively, all residual tumor lining was cleared from the proximal femur. Following the fixation of the definitive prostheses, stable hip reduction was attained. Enhanced posterior soft tissue repair was performed. He was permitted partial weight-bearing for six weeks post-operatively, and full weight-bearing thereafter. At 24 years post-operatively, the patient had a Harris Hip Score of 97, with no radiologic evidence of osteolysis or component loosening.
Conclusion:
Aneurysmal bone cysts primarily affect young individuals. Their initial treatment, therefore, should focus on joint-preserving modalities. However, total hip arthroplasty must be considered for suspected recurrent aneurysmal bone cysts with pathologic fractures of the neck of the femur in patients with extensive bone loss and poor-quality residual bone. |
| format | Article |
| id | doaj-art-b0fc75628b9a4559801bcc13c0080bb6 |
| institution | Kabale University |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-b0fc75628b9a4559801bcc13c0080bb62025-08-20T03:36:45ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-07-01157232710.13107/jocr.2025.v15.i07.5754Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case ReportJavahir A PachoreVikram I ShahH R JhunjhunwallaClint BabuApurve ParameswaranKrishna Kiran EachempatiIntroduction: The approach to the management of aneurysmal bone cysts has evolved over time, with the focus shifting from surgery to less invasive therapeutic modalities. Curettage with or without bone grafting was considered the procedure of choice until recently but is associated with high recurrence rates. The management of recurrent aneurysmal bone cysts is challenging, especially in the presence of pathologic fractures. Scant literature is available on total hip arthroplasty for aneurysmal bone cysts of the proximal femur. Case Report: A 27-year-old man underwent extended curettage and bone grafting for an aneurysmal bone cyst of the right proximal femur in 1999. He presented to the emergency department 17 months after the surgery with a recurrence of the aneurysmal bone cyst and a pathologic fracture of the right femoral neck. He underwent cementless total hip arthroplasty with a ceramic-on-ceramic articulation. Intraoperatively, all residual tumor lining was cleared from the proximal femur. Following the fixation of the definitive prostheses, stable hip reduction was attained. Enhanced posterior soft tissue repair was performed. He was permitted partial weight-bearing for six weeks post-operatively, and full weight-bearing thereafter. At 24 years post-operatively, the patient had a Harris Hip Score of 97, with no radiologic evidence of osteolysis or component loosening. Conclusion: Aneurysmal bone cysts primarily affect young individuals. Their initial treatment, therefore, should focus on joint-preserving modalities. However, total hip arthroplasty must be considered for suspected recurrent aneurysmal bone cysts with pathologic fractures of the neck of the femur in patients with extensive bone loss and poor-quality residual bone.https://jocr.co.in/wp/2025/07/01/twenty-four-year-follow-up-of-successful-total-hip-arthroplasty-for-recurrent-proximal-femoral-aneurysmal-bone-cyst-with-a-pathologic-fracture-following-extended-curettage-and-bone-grafting-a-case-re/aneurysmal bone cysttotal hip arthroplastypathologic fractureextended curettagebone tumorceramic-on-ceramic |
| spellingShingle | Javahir A Pachore Vikram I Shah H R Jhunjhunwalla Clint Babu Apurve Parameswaran Krishna Kiran Eachempati Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report Journal of Orthopaedic Case Reports aneurysmal bone cyst total hip arthroplasty pathologic fracture extended curettage bone tumor ceramic-on-ceramic |
| title | Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report |
| title_full | Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report |
| title_fullStr | Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report |
| title_full_unstemmed | Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report |
| title_short | Twenty-Four-Year Follow-up of Successful Total Hip Arthroplasty for Recurrent Proximal Femoral Aneurysmal Bone Cyst with a Pathologic Fracture Following Extended Curettage and Bone Grafting: A Case Report |
| title_sort | twenty four year follow up of successful total hip arthroplasty for recurrent proximal femoral aneurysmal bone cyst with a pathologic fracture following extended curettage and bone grafting a case report |
| topic | aneurysmal bone cyst total hip arthroplasty pathologic fracture extended curettage bone tumor ceramic-on-ceramic |
| url | https://jocr.co.in/wp/2025/07/01/twenty-four-year-follow-up-of-successful-total-hip-arthroplasty-for-recurrent-proximal-femoral-aneurysmal-bone-cyst-with-a-pathologic-fracture-following-extended-curettage-and-bone-grafting-a-case-re/ |
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