Polidocanol Sclerotherapy With Bone Marrow Injection Effective for Aneurysmal Bone Cysts: Study

Use of polidocanol sclerotherapy followed by adjuvant autogenous bone marrow injection for management of ABCs is highly effective, according to a new study. 

Aneurysmal bone cysts (ABCs) are benign bone lesions that exhibit localized destructive growth. Conventionally, most patients are treated with curettage and bone grafting. Alternatively, percutaneous treatment using selective arterial embolization and sclerotherapy had been successfully used with promising results. Adjuvant use of bone marrow injection alone or with other agents for treatment of bone cysts was previously used.

Ehab Abdelfattah Elshal et al conducted a study to assess the clinical outcome of polidocanol sclerotherapy with adjuvant autogenous bone marrow injection for management of ABCs.

The present prospective study was conducted on 20 patients with ABCs diagnosed on the basis of clinical and radiological findings. All patients were managed using polidocanol sclerotherapy followed by adjuvant autogenous bone marrow injection. Pain was evaluated using Visual Analog Scale (VAS). Radiographic evaluation was performed using plain radiographs. All patients were followed for 30 months after the last treatment session.

The key findings of the study were:

• The present study was conducted on 20 patients with an age of 10.2 ± 4.4 years (range: 3.0·20.0 years).

• They comprised 12 males and 8 females.

• VAS for pain improved from 6.2 ± 1.4 at baseline to 0.3 ± 0.5 ( p < 0.001) at the end of follow-up.

• Radiologically, cyst volume significantly decreased from 79.9 ± 26.3 ml to 2.0 ± 2.1 ml ( p < 0.001).

• Reported complications included recurrence (5.0%), ecchymosis (10.0%), and nausea and vomiting (5.0%).

The authors concluded – “Use of polidocanol sclerotherapy followed by adjuvant autogenous bone marrow injection for management of ABCs is highly effective with adequate safety profile.”

“Conclusions of this study may be limited by the relatively small sample size which may affect the detection of rare complications. Also, the study is single-center and lack comparison to other possible interventions or controls. Further studies are recommended to assess the mechanistic link between use of autologous bone marrow injection in addition to polidocanol sclerotherapy and clinical response. Randomized clinical studies are also recommended to compare the clinical efficacy to other interventions.” - the authors opined.

For further details on the article refer to:

Polidocanol Sclerotherapy Plus Adjuvant Autogenous Bone Marrow Injection for Management of Aneurysmal Bone Cyst: A Prospective Study

Ehab Abdelfattah Elshal et al

Indian Journal of Orthopaedics (2026) 60:1612·1618

https://doi.org/10.1007/s43465-025-01648-3