Solitary Bone Cyst of the Proximal Humerus with a Concomitant Stiff Shoulder Treated with both Arthroscopic Capsular Release and Arthroscope-Assisted Resection of the Bone Cyst: A Case Report

摘要

Solitary bone cysts are benign bone lesions that usually occur in the humerus, calcaneus, and femur of children and adolescents. When present in adults, they are usually diagnosed as incidental findings. In this report, we present an adult case of a solitary bone cyst of the proximal humerus with concomitant refractory stiff shoulder treated with both arthroscopic capsular release and arthroscope-assisted resection of the bone cyst. A 73-year-old woman was referred with a complaint of persistent left shoulder pain and limited range of motion. Magnetic resonance imaging showed an approximately 4.5-cm long diameter cystic bone lesion from the humeral neck to the shaft. At first, arthroscopic synovectomy and pan-capsular release were performed. Next, two 1-cm skin incisions and 8-mm drill holes into the lateral wall of the cyst were created with fluoroscopic guidance. After insertion of the arthroscope through the holes, the white membranous cyst wall was resected with a shaver until bone marrow was observed. Finally, an 8-mm cannulated hydroxyapatite pin was inserted. This is a simple technique that allows direct visualization and complete resection of the cyst wall with two small incisions. Such a technique may be superior to conventional open procedures or those under image guidance.