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Untreated Asymptomatic Hips in Patients With Osteonecrosis of the Femoral Head

  • Symposium: Molecular and Surgical Advances in Osteonecrosis
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Because there is no consensus regarding the factors predicting femoral head collapse in asymptomatic osteonecrosis of the hip, we studied the risk factors for collapse. Between 1990 and 2000, we used MRI to confirm asymptomatic osteonecrosis of the femoral head in 81 patients (81 hips) whose other hip had nontraumatic symptomatic osteonecrosis and we monitored them prospectively. The minimum followup was 5 years (mean, 8.3 years; range, 5–16 years). At the latest followup, 31 hips (38%) were symptomatic and 26 hips (32%) had collapsed. The mean interval between diagnosis and collapse was 4.1 years. We observed no correlation between femoral head collapse and patients’ age, gender, weight, presumed cause of osteonecrosis, or length of followup. With combined factors, only extent of large necrotic lesion (hazard ratio, 4.06; 95% confidence interval, 1.29–12.77) and location of Type C2 necrotic lesion (hazard ratio, 6.35; 95% confidence interval, 1.18–34.11) predicted collapse.

Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keimyung University, School of Medicine, Dongsan Medical Center, 194 Dongsan-dong, Joong-gu, Daegu, 700-712, Korea

    Byung-Woo Min MD, Kwang-Soon Song MD, Chul-Hyun Cho MD, Sung-Moon Lee MD & Kyung-Jae Lee MD

Authors
  1. Byung-Woo Min MD
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  2. Kwang-Soon Song MD
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  3. Chul-Hyun Cho MD
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  4. Sung-Moon Lee MD
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  5. Kyung-Jae Lee MD
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Correspondence to Byung-Woo Min MD.

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Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patient/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Min, BW., Song, KS., Cho, CH. et al. Untreated Asymptomatic Hips in Patients With Osteonecrosis of the Femoral Head. Clin Orthop Relat Res 466, 1087–1092 (2008). https://doi.org/10.1007/s11999-008-0191-x

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  • DOI: https://doi.org/10.1007/s11999-008-0191-x

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