Jang Woo Young, Lee Soon Hyuck, Cho Il Youp
Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Inchon-ro, Seoul, Sungbuk-Gu, 02841, Republic of Korea.
Skeletal Radiol. 2017 Apr;46(4):553-557. doi: 10.1007/s00256-017-2570-4. Epub 2017 Jan 22.
This article highlights that the long-term and serial follow-up of adolescents with osteoid osteoma should be considered, even after complete excision of the nidus owing to the possibility of the delayed onset or progression of femur head and neck deformities or osteoarthritis. It is important to recognize the sequelae of osteoid osteomas, such as bone edema and new bone formation, which can alter the normal anatomy of the proximal femur. We report two cases of osteoid osteoma in the proximal femur, which showed progressive hypertrophy of the femoral neck after excision of the nidus and subsequent cam-type femoroacetabular impingement (FAI), requiring additional osteochondroplasty procedures. Even though hip pain was relieved immediately after excision of the nidus in both cases, cam-type FAI developed during postoperative follow-up of 18 months (case 1) and 6.5 years (case 2). Hip pain subsided within 1 month of osteochondroplasty, and the full range of motion of the hip joint was achieved and was being maintained after postoperative follow-up of 1 year (case 1) and 6 months (case 2).
本文强调,即使骨样骨瘤的瘤巢已完全切除,仍应考虑对青少年进行长期连续随访,因为股骨头和颈部畸形或骨关节炎可能会延迟出现或进展。认识到骨样骨瘤的后遗症很重要,如骨水肿和新骨形成,它们会改变股骨近端的正常解剖结构。我们报告了两例股骨近端骨样骨瘤病例,在切除瘤巢后出现股骨颈渐进性肥大,随后发生凸轮型股骨髋臼撞击症(FAI),需要额外进行骨软骨成形术。尽管两例患者在切除瘤巢后髋部疼痛立即缓解,但在术后18个月(病例1)和6.5年(病例2)的随访中出现了凸轮型FAI。骨软骨成形术后1个月内髋部疼痛消退,术后1年(病例1)和6个月(病例2)随访时髋关节达到并维持了全范围活动。