Forty-four patients with aneurysmal bone cysts were treated with curet
tage with or without bone grafting, and in 26 (59%) recurrence develop
ed. Of 11 patients treated with radiation, in only 1 (9%) the disease
was not controlled. In 1 patient, radiation-induced sarcoma developed.
Since the introduction of cryosurgery 27 years ago, 51 patients have
been treated with cryosurgery. The patients had an average age of 13 y
ears (range, 2-32 years). Thirty-four primary aneurysmal bone cysts an
d 17 secondary aneurysmal bone cysts occurred in association with 7 gi
ant-cell tumors, 5 chondroblastomas, 2 fibromyxomas, 2 nonossifying fi
bromas, and 1 unicameral bone cyst. The tumors were classified as inac
tive in 9 patients, active in 31, and aggressive in 11. Treatment cons
isted of local intralesional excision followed by application of liqui
d nitrogen. The defect was either allowed to heal spontaneously (n = 2
6) or was reconstructed using an intramedullary rod (n = 2), bone graf
ts (n = 5), fibular strut grafts (n = 14), or polymethylmethacrylate w
ith Steinmann pins (n = 4). At median followup of 85 months (range, 24
-311 months), the overall cure rate was 82%. This was increased to 96%
after a second, or repeat, cryosurgery. The disease in all patients e
ventually was controlled by cryosurgery. The mean functional rating wa
s 90% (range, 63%-100%). Intralesional excision with adjunctive cryosu
rgery is an effective method for the treatment of aneurysmal bone cyst
.