Intraoperative Cryotherapy as a Local Adjuvant After Bone Curettage in Orthopedic Oncology: A Review of Modern Literature

Background: Curettage is a well-established treatment for benign bone tumors. Among the adjuvant treatments available to minimize the risk of local recurrence after curettage, cryotherapy is one of the most used and documented. Our study aims to summarize the results of curettage and intraoperative cryotherapy for the treatment of bone tumors in the modern literature. Methods: We systematically reviewed the existing literature, searching for cases treated with intraoperative cryotherapy after bone curettage in orthopedic oncology. Articles from the PubMed and MEDLINE databases, published between January 2000 and January 2025, were included. Our research was conducted in accordance with PRISMA guidelines. Case reports were excluded. For each study, we recorded the number of cases, their histological diagnosis, the curettage technique, and the cryotherapy administration strategy. Complications and recurrence rates were recorded, as well as post-operative functional performance. Results: Twenty-two studies met our inclusion criteria. A total of 1451 cases with benign and low-grade malignant bone tumors were recorded. After a mean follow-up of 55.7 months, the mean recurrence rate was 7.4% and the global complication rate was 8.7%. The mean MSTS score was 27.8. Conclusions: The combination of curettage and intra-operative cryotherapy, administered with either open or closed contact techniques, can be effective in eradicating benign and low-grade bone tumors and has low complication rates and a limited impact on patients’ functionality.