Results of Operative Treatment for a Bone Cyst in the Proximal Femur

Myung-Sik Park; Do-Hyun Kim; Hong-Man Cho; Woo-Chull Chung

doi:10.5371/jkhs.2011.23.1.54

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Park, Kim, Cho, and Chung: Results of Operative Treatment for a Bone Cyst in the Proximal Femur

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2011; 23(1): 54-59.

Published online: 31 March 2011

DOI: https://doi.org/10.5371/jkhs.2011.23.1.54

Results of Operative Treatment for a Bone Cyst in the Proximal Femur

Myung-Sik Park, MD, Do-Hyun Kim, MD, Hong-Man Cho, MD^*, Woo-Chull Chung, MD^†

Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University School of Medicine, Jeonju, Korea.

^*Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea.

^†Department of Orthopedic Surgery, Busan Veterans Hospital, Busan, Korea.

Address reprint request to Hong-Man Cho, MD. Department of Orthopedic Surgery, Gwangju Veterans Hospital, 887-1 Sanwol-dong, Gwangsan-gu, Gwangju 506-705, Korea. TEL: +82-62-602-6162, FAX: +82-62-602-6989, chm1228@hanmail.net

Received 1 September 2010 Revised 22 February 2011 Accepted 24 February 2011

Abstract

Purpose

We retrospectively evaluated performing curettage and bone grafting for the treatment of simple bone cyst in 21 patients with cysts in the proximal femur. The purpose of this study was to review the results with a minimum follow up of 24 months.

Materials and Methods

We treated 21 cases of simple bone cysts with curettage and a bone graft from June 1995 to July 2008. 4 male and 17 female patients (age range: 14~62 years (mean age: 39.8 years) volunteered for this study. The range of the follow-up period was from 24 months to 6 years (mean follow-up: 63.7 months). We evaluated the effect of treatment by examining the simple follow-up radiographs according to Oppenheim's classification. We retrospectively reviewed the site of the cysts, the patients' ages at the time of the diagnosis, the incidence of pathologic fracture, the association with femoro-acetabular impingement (FAI) and the type of bone graft.

Results

The investigation revealed that 20 out of 21 patients had better than improved results. 14 patients of the 15 patients who were treated with an autogenous bone graft had better than improved results and all 6 patients who received an autogenous and allergenic bone graft had better than improved results. Two patients had associated FAI. These cases were managed with arthroscopic labral trimming and curettage. There were no specific complications related to the bone cyst and the operative procedure.

Conclusion

We believe curettage and bone grafting and stabilization with compression hip screws is a reasonable treatment for simple bone cysts in the proximal femur. The bone cyst in the femoral head neck junction in patients older than 50 years old is related with femoroacetabular impingement.

Keywords: Bone cyst, Bone graft

Figures and Tables

Fig. 1

Radiographs of a 29 year-old female who presented with right hip pain. (A) The bony cyst is mainly located in the head and neck region. (B) Radiographs taken after the operation (Fixation with compression hip screw after curettage and autogenous bone graft). (C) AP views taken 36 months after operation.

Fig. 2

Radiographs of a 62-year-old female who presented with right hip pain. (A) The bony cyst is mainly located in the neck region but partly involves the femoral head. (B) Magnetic resonance image of the right hip, an intraosseous cyst (herniation fit) can be seen to the anterosuperoir aspect of the femoral head-neck junction and pincer type FAI also. (C) Radiographs taken after operation (Fixation with compression hip screw after curettage and autogenous bone graft). (D) AP views taken 28 months after operation.

Table 1

Demographic Data

^*FAI; Femoro Acetabular Impingement

^†FU; Follow Up

^‡N & T; Neck and Trochanteric

^§H & N; Head and Neck

^∥CHS; Compression Hip Screw

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