Abstract
Purpose
Once collapsed, osteonecrosis of the femoral head (ONFH) generally obtains collapse cessation naturally and surgical intervention can be avoided in the long term. This study aimed to investigate the process of hip function and secondary osteoarthritis changes in ONFH patients undergoing conservative treatment.
Methods
We included 54 patients with symptomatic ONFH at the first visit with a minimum follow-up of three years with conservative treatment. Patients were divided into two groups based on collapse cessation < 3 mm (stable group) or progression to > 3 mm (progression group). Additionally, we investigated age, sex, body mass index (BMI), etiology, contralateral side hip joint, the Japanese Investigation Committee (JIC) type classification, Harris hip score (HHS), Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and survival rate with secondary osteoarthritis as the endpoint.
Results
The stable and progression groups had 31 and 23 patients, respectively. No significant differences in age, sex, BMI, and aetiology were observed between the two groups, except for the contralateral side hip joint and JIC type classification. The HHS and JHEQ were significantly improved at the final follow-up than at the first visit in the stable group. However, there were no significant differences in HHS and JHEQ at the final follow-up than at the first visit in the progression group. The five year survival rates with secondary osteoarthritis as the endpoint were significantly higher in the stable group (100%) than in the progression group (32.5%).
Conclusion
Hip joint function improved by continuing conservative treatment in ONFH patients with collapse cessation < 3 mm.
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Not applicable.
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Y. Osawa: study designed, data collection, data analysis, image assessment, statistical analysis, writing the paper. Y. Takegami: statistical analysis, study designed. D Kato: image assessment, data collection. M Okamoto: data collection. H Iida: data collection. S. Imagama: proofreading of the final paper.
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This investigational protocol was conducted with the approval of the Nagoya University Graduate School of Medicine Ethics Committee. In accordance with the requirements of this review, all subjects provided informed consent.
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Osawa, Y., Takegami, Y., Kato, D. et al. Hip function in patients undergoing conservative treatment for osteonecrosis of the femoral head. International Orthopaedics (SICOT) 47, 89–94 (2023). https://doi.org/10.1007/s00264-022-05569-w
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DOI: https://doi.org/10.1007/s00264-022-05569-w