Aigner C, Ehall R, Stampfel O
Klinische Abteilung für Orthopädie, Universitätsklinik für Chirurgie, Graz.
Wien Klin Wochenschr. 1995;107(23):726-30.
Radioosteonecrosis of the acetabulum is a rare side effect of radiotherapy. The latency period of 2 to 17 years is much longer than that reported for other bones (1-3 years). The reason for this is unknown. Plane radiograms show sclerosis, cysts and fractures of the acetabulum and, in most cases, a migration of the femoral head with flattening. The diagnosis of a radioosteonecrosis has to be made by exclusion of malignomas by scintigraphy and MRT or CT. This paper presents the follow-up of four patients treated by total hip replacement (THR) for radioosteonecrosis of the acetabulum. Within 9 months postoperatively the fractures of the acetabulum had healed with full weight bearing. 36 to 78 months after operation no signs of progression of the bone changes were detected. In this period the loosening of one spherical thread cup occurred, but a radiolucent gap above a cemented cup stayed unchanged. We conclude that irradiation damage of the acetabulum can be treated successfully by THR even in cases with fractures of the acetabulum as far as a stable implantation can be achieved and the remaining osteoblasts are preserved by the procedure.
髋臼放射性骨坏死是放射治疗罕见的副作用。其2至17年的潜伏期远长于其他骨骼所报告的潜伏期（1至3年）。原因不明。X线平片显示髋臼硬化、囊肿和骨折，多数情况下股骨头移位伴扁平。放射性骨坏死的诊断必须通过骨闪烁显像、磁共振成像（MRT）或计算机断层扫描（CT）排除恶性肿瘤来作出。本文介绍了4例因髋臼放射性骨坏死接受全髋关节置换术（THR）患者的随访情况。术后9个月内，髋臼骨折在完全负重情况下愈合。术后36至78个月未检测到骨改变进展的迹象。在此期间，1个球形螺纹杯出现松动，但骨水泥固定杯上方的透亮间隙保持不变。我们得出结论，即使在髋臼骨折的情况下，只要能实现稳定植入且手术能保留剩余成骨细胞，全髋关节置换术就能成功治疗髋臼的放射损伤。
