髋关节发育不良髋臼骨囊性变的特征

目的观察髋关节发育不良（DDH）继发骨性关节炎时髋臼骨囊性变的位置和大小，为全髋关节置换术（THR）中髋臼重建提供参考。方法回顾性分析2007年6月—2008年11月我院行THR的DDH患者的临床资料，共38例（45髋）；以同期行THR的38例（45髋）原发性髋关节骨性关节炎作为对照组，在髋关节正位x线片和螺旋CT扫描片上观察髋臼骨囊性变的位置，测量骨囊性变的大小。结果DDH组髋关节正位片发现16侧髋臼存在骨囊性变，螺旋CT扫描片发现21侧髋臼存在骨囊性变，髋臼冠状面测定囊变面积为（4．7±5．1）mm2。对照组髋关节正位片发现6侧髋臼存在骨囊性变，螺旋CT片发现10侧髋臼存在骨囊性变，囊变区面积为（1．3±2．4）mm2，两组间骨囊性变的发生率和面积差异均有统计学意义（P值均〈0．05）。结论DDH继发骨性关节炎的髋臼存在高发的骨囊性变。在THR髋臼重建过程中应对其进行刮除植骨，否则可能影响到髋臼假体的稳定性。

Characteristics of acetabular bony cyst in patients with developmental dysplasia of the hip

Objective To observe the position and size of acetabalar bony cyst in patients with hip osteoarthritis secondary to developmental dysplasia of the hip （ DDH）, and provide a basis for the acetabular reconstruction during total hip replacement （THR）. Methods Thirty-eight patients （45 hips） with hip osteoarthritis secondary to DDH were retrospectively observed, who performed THR in our hospital from June 2007 to November 2008. The patients with primary hip osteoarthritis in this period in our hospital performed THR were treated as the control group. The position and the size of acetabular bony cyst were evaluated in the hip anteroposterior film and hip helical computed tomography. Results There were 16 acetabular bone cyst in hip anteroposterior film, and 21 acetabular bone cyst in the helical CT scan, in the patients with DDH. And its area ranged （4.7 ± 5.1 ） mm2 in the frontal plane of the acetabula. The acetabular bony cyst presented in 6 acetabula in hip anteroposterior film, and in 10 acetabula in the helical CT scan, and its area ranged （ 1.3 ± 2.4） mm2 in the frontal plane of the acetabula, in the control group. The incidence and the area of acetabular bony cyst had a significant difference （P 〈 0.05 ） between the two groups. Conclusions There is a high incidence of acetabular bony cyst in patients with hip osteoarthritis secondary to DDH. Bony cyst should be coped with in the process of acetabular reconstruction, or may influence the stability of acetabular prosthesis.