J Korean Hip Soc.  2011 Mar;23(1):54-59. 10.5371/jkhs.2011.23.1.54.

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

• Park MS
• Kim DH
• Cho HM
• Chung WC

• KMID: 2190776
• DOI: http://doi.org/10.5371/jkhs.2011.23.1.54

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.

Keyword

Bone cyst; Bone graft

MeSH Terms

Bone Cysts
Bone Transplantation
Curettage
Female
Femoracetabular Impingement
Femur
Follow-Up Studies
Fractures, Spontaneous
Head
Hip
Humans
Incidence
Male
Neck
Retrospective Studies
Transplants

Figure

• 

  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.

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