Dürr Hans D, Martin Heiner, Pellengahr Christoph, Schlemmer Marcus, Maier Markus, Jansson Volkmar
Department of Orthopaedics and Orthopaedic Surgery, Ludwig-Maximilians-University Munich, Klinikum Grosshadern, Marchioninistr. 15, DE-81366 Munich, Germany.
Acta Orthop Scand. 2004 Oct;75(5):554-8. doi: 10.1080/00016470410001411.
The etiology of subchondral bone cysts in arthrotic joints is unclear.
We used two-dimensional finite element analysis to evaluate the hypothesis that subchondral bone cysts in the osteoarthrotic hip joint may be the result of microfractures caused by localized cartilage defects or a thinned layer of cartilage. We evaluated the equivalent bone stress (von Mises (VM) stress) in the cancellous bone as an indicator of potential microfractures and further development of cystic lesions.
Cartilage defects induced stress peaks in the subchondral bone. This peak stress distribution corresponded to the clinical observation of development of acetabular and femoral subchondral cysts in a "kissing" position. A femoral subchondral bone cyst induced a stress peak at the corresponding acetabular site, whereas subchondral acetabular cysts did not increase stress in the femoral head. Acetabular cysts showed an increased level of stress at the lateral and medial border of the lesion which was much higher than the stress levels in the femoral head, indicating a tendency to faster growth.
Our study supports the theory that stress-induced bone resorption may cause development of subchondral bone cysts in osteoarthrosis.
关节软骨下骨囊肿的病因尚不清楚。
我们使用二维有限元分析来评估以下假设，即骨关节炎性髋关节中的软骨下骨囊肿可能是由局部软骨缺损或软骨层变薄引起的微骨折所致。我们将松质骨中的等效骨应力（冯·米塞斯（VM）应力）作为潜在微骨折和囊性病变进一步发展的指标进行评估。
软骨缺损在软骨下骨中引起应力峰值。这种峰值应力分布与髋臼和股骨软骨下囊肿在“亲吻”位置发展的临床观察结果相符。股骨软骨下骨囊肿在相应的髋臼部位引起应力峰值，而髋臼软骨下囊肿并未增加股骨头的应力。髋臼囊肿在病变的外侧和内侧边缘显示出应力水平升高，远高于股骨头的应力水平，表明有更快生长的趋势。
我们的研究支持这样一种理论，即应力诱导的骨吸收可能导致骨关节炎中软骨下骨囊肿的形成。
