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Erschienen in: International Orthopaedics 2/2016

01.02.2016 | Original Paper

Multicentric epidemiologic study on six thousand three hundred and ninety five cases of femoral head osteonecrosis in China

verfasst von: Liqiang Cui, Qianyu Zhuang, Jin Lin, Jin Jin, Ke Zhang, Li Cao, Jianhao Lin, Shigui Yan, Wanshou Guo, Wei He, Fuxing Pei, Yixin Zhou, Xisheng Weng

Erschienen in: International Orthopaedics | Ausgabe 2/2016

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Abstract

Purpose

Osteonecrosis of femoral head (ONFH) is a common joint disease with high morbidity in mainland China. We performed a retrospective case investigation based on the widest range of patients ever to reveal the demographic and clinical characteristics of ONFH in mainland China.

Methods

We collected data from hospitalized patients of nine large tertiary hospitals in China, focusing on the aetiology of ONFH. Medical records and self-design questionnaires were used to collect data. We determined the patients’ aetiology according to established guidelines and categorized patients into different subgroups. We further analysed the underlying illness of the steroid-induced osteonecrosis of femoral head.

Results

A total of 6,395 patients with complete medical records were included in the study. The age (mean ± SD) of the patients was 46.45 ± 13.80 years. Males dominate with 70.1 % of all ONFH patients. In all the ONFH patients, 24.1 % are steroid induced, 30.7 % are alcoholic, 16.4 % are traumatic and 28.8 % are idiopathic. Among steroid-induced osteonecrosis of femoral head patients, 546 patients have autoimmune disorder (46.63 %), which is the most common underling illness, among these, the most common disease is systemic lupus erythematosus (SLE).

Conclusions

The most common age when ONFH occurs is between 40 and 50 years old. Male patients developed ONFH 3.4 years earlier than female patients. The number of the male patients is greater than the female, reaching the overall gender proportion of 7:3. Autoimmune disease is the primary cause of steroid-induced ONFH, among which SLE is the most common disease.
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Literatur
1.
Zurück zum Zitat Mont MA, Zywiel MG (2010) The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg 92:2165–2170CrossRefPubMed Mont MA, Zywiel MG (2010) The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg 92:2165–2170CrossRefPubMed
2.
Zurück zum Zitat Lieberman JR, Engstrom SM, Meneghini RM, SooHoo NF (2012) Which factors influence preservation of the osteoneerotie femoral head? Clin Orthop Relat Res 470:525–534PubMedCentralCrossRefPubMed Lieberman JR, Engstrom SM, Meneghini RM, SooHoo NF (2012) Which factors influence preservation of the osteoneerotie femoral head? Clin Orthop Relat Res 470:525–534PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Kang JS, Park S, Song JH, Jung YY, Cho MR, Rhyu KH (2009) Prevalence of osteonecrosis of the femoral head: a nationwide epidemiologic analysis in Korea. J Arthroplasty 24:1178–1183CrossRefPubMed Kang JS, Park S, Song JH, Jung YY, Cho MR, Rhyu KH (2009) Prevalence of osteonecrosis of the femoral head: a nationwide epidemiologic analysis in Korea. J Arthroplasty 24:1178–1183CrossRefPubMed
4.
Zurück zum Zitat Fukushima W, Fujioka M, Kubo T, Tamakoshi A, Nagai M, Hirota Y (2010) Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res 468:2715–2724PubMedCentralCrossRefPubMed Fukushima W, Fujioka M, Kubo T, Tamakoshi A, Nagai M, Hirota Y (2010) Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res 468:2715–2724PubMedCentralCrossRefPubMed
5.
Zurück zum Zitat Desforges JF, Mankin HJ (1992) Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 326:1473–1479CrossRef Desforges JF, Mankin HJ (1992) Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 326:1473–1479CrossRef
6.
Zurück zum Zitat Gardniers JW (1993) ARCO committee on terminology and staging (report on the committee meeting at Santiago de Compostela). ARCO News Lett 5:79–82 Gardniers JW (1993) ARCO committee on terminology and staging (report on the committee meeting at Santiago de Compostela). ARCO News Lett 5:79–82
7.
Zurück zum Zitat Jacobs B (1978) Epidemiology of traummatic and nontraumatic osteonecrosis. Clin Orthop Relat Res 130:51–67PubMed Jacobs B (1978) Epidemiology of traummatic and nontraumatic osteonecrosis. Clin Orthop Relat Res 130:51–67PubMed
8.
Zurück zum Zitat Ju TG, Chen WH (2009) Research progress of epidemiology about non-traumatic osteonecrosis of femoral head. Med Recapitulate 15:2637–2639 Ju TG, Chen WH (2009) Research progress of epidemiology about non-traumatic osteonecrosis of femoral head. Med Recapitulate 15:2637–2639
9.
Zurück zum Zitat Liu L (2007) Clinical analysis of osteonecrosis of femoral head. Chinese J Conva Med 16:447CrossRef Liu L (2007) Clinical analysis of osteonecrosis of femoral head. Chinese J Conva Med 16:447CrossRef
10.
Zurück zum Zitat Mont MA, Hungerford DS (1995) Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am 77:459–474PubMed Mont MA, Hungerford DS (1995) Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am 77:459–474PubMed
11.
Zurück zum Zitat Ficat RP (1985) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br 6:3–9 Ficat RP (1985) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br 6:3–9
12.
Zurück zum Zitat Banaszkiewicz PA (2014) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. In: Kader DF (ed) Classic papers in orthopaedics. Springer, London, pp 121–123CrossRef Banaszkiewicz PA (2014) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. In: Kader DF (ed) Classic papers in orthopaedics. Springer, London, pp 121–123CrossRef
13.
Zurück zum Zitat Matsuo K, Hirohata T, Sugioka Y, Ikeda M, Fukuda A (1988) Influence of alcohol intake, cigarette-smoking, and occupational-status on idiopathic osteonecrosis of the femoral-head. Clin Orthop Relat Res 234:115–123 Matsuo K, Hirohata T, Sugioka Y, Ikeda M, Fukuda A (1988) Influence of alcohol intake, cigarette-smoking, and occupational-status on idiopathic osteonecrosis of the femoral-head. Clin Orthop Relat Res 234:115–123
14.
Zurück zum Zitat Jones LC, Hungerford DS (2004) Osteonecrosis: etiology, diagnosis, and treatment. Curr Opin Rheumatol 16:443–449CrossRefPubMed Jones LC, Hungerford DS (2004) Osteonecrosis: etiology, diagnosis, and treatment. Curr Opin Rheumatol 16:443–449CrossRefPubMed
15.
Zurück zum Zitat Gao YH, Li SQ, Wang YF, Yang C, Liu JG, Qi X (2015) Arthroplasty in patients with extensive femoral head avascular necrosis: Cementless arthroplasty in extensive femoral head necrosis. Int Orthop 39(8):1507–11CrossRefPubMed Gao YH, Li SQ, Wang YF, Yang C, Liu JG, Qi X (2015) Arthroplasty in patients with extensive femoral head avascular necrosis: Cementless arthroplasty in extensive femoral head necrosis. Int Orthop 39(8):1507–11CrossRefPubMed
16.
Zurück zum Zitat Yu T, Xie L, Zhang Z, Ke X, Liu Y (2015) Prediction of osteonecrosis collapse of the femoral head based on the proportion of the proximal sclerotic rim. Int Orthop 39(6):1045–50CrossRefPubMed Yu T, Xie L, Zhang Z, Ke X, Liu Y (2015) Prediction of osteonecrosis collapse of the femoral head based on the proportion of the proximal sclerotic rim. Int Orthop 39(6):1045–50CrossRefPubMed
17.
Zurück zum Zitat Coventry MB, Beckenbaugh RD, Nolan DR, Ilstrup DM (1974) 2,012 total hip arthroplasties: a study of postoperative course and early complications. J Bone Joint Surg Am 56:273–284PubMed Coventry MB, Beckenbaugh RD, Nolan DR, Ilstrup DM (1974) 2,012 total hip arthroplasties: a study of postoperative course and early complications. J Bone Joint Surg Am 56:273–284PubMed
18.
Zurück zum Zitat Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y, Gershwin ME (2002) Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 32:94–124CrossRefPubMed Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y, Gershwin ME (2002) Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 32:94–124CrossRefPubMed
19.
Zurück zum Zitat Tan G, Kang PD, Pei FX (2012) Glucocorticoids affect the metabolism of bone marrow stromal cells and lead to osteonecrosis of the femoral head: a review. Chin Med J 125:134–139PubMed Tan G, Kang PD, Pei FX (2012) Glucocorticoids affect the metabolism of bone marrow stromal cells and lead to osteonecrosis of the femoral head: a review. Chin Med J 125:134–139PubMed
20.
Zurück zum Zitat Yin L, Li YB, Wang YS (2006) Dexamethasone-induced adipogenesis in primary marrow stromal cell cultures: mechanism of steroid-induced osteonecrosis. Chin Med J (Engl) 119:581–588 Yin L, Li YB, Wang YS (2006) Dexamethasone-induced adipogenesis in primary marrow stromal cell cultures: mechanism of steroid-induced osteonecrosis. Chin Med J (Engl) 119:581–588
21.
Zurück zum Zitat Koo KH, Kim R, Kim YS, Ahn IO, Cho SH, Song HR, Park YS, Kim H, Wang G (2002) Risk period for developing osteonecrosis of the femoral head in patients on steroid treatment. Clin Rheumatol 21:299–303CrossRefPubMed Koo KH, Kim R, Kim YS, Ahn IO, Cho SH, Song HR, Park YS, Kim H, Wang G (2002) Risk period for developing osteonecrosis of the femoral head in patients on steroid treatment. Clin Rheumatol 21:299–303CrossRefPubMed
22.
Zurück zum Zitat Kuga Y (2000) Factors associated with osteonecrosis in the femoral head in chronic alcoholism. Kurume Med J 47:147–149CrossRefPubMed Kuga Y (2000) Factors associated with osteonecrosis in the femoral head in chronic alcoholism. Kurume Med J 47:147–149CrossRefPubMed
23.
Zurück zum Zitat Jacobs B (1992) Alcoholism-induced bone necrosis. NY State J Med 92:334–338 Jacobs B (1992) Alcoholism-induced bone necrosis. NY State J Med 92:334–338
24.
Zurück zum Zitat Shih CH, Yang WE, Lee ZL, Kao YL, Hsueh S, Wei JS (1991) Effect of long-term alcohol ingestion on the femoral head of rabbit. J Formos Med Assoc 90:443–447PubMed Shih CH, Yang WE, Lee ZL, Kao YL, Hsueh S, Wei JS (1991) Effect of long-term alcohol ingestion on the femoral head of rabbit. J Formos Med Assoc 90:443–447PubMed
26.
Zurück zum Zitat Jacobson DL, Gange SJ, Rose NR, Graham NM (1997) Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 84:223–243CrossRefPubMed Jacobson DL, Gange SJ, Rose NR, Graham NM (1997) Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 84:223–243CrossRefPubMed
27.
Zurück zum Zitat Kenzora JE (1983) Ischemic necrosis of femoral head. Part I. Accumulative cell stress: a hypothesis for the etiology of idiopathic osteonecrosis. Instr Course Lect 32:242–252PubMed Kenzora JE (1983) Ischemic necrosis of femoral head. Part I. Accumulative cell stress: a hypothesis for the etiology of idiopathic osteonecrosis. Instr Course Lect 32:242–252PubMed
28.
Zurück zum Zitat Van den Heuvel-Eibrink MM, Pieters R (2012) Steroids and risk of osteonecrosis in ALL: take a break. Lancet Oncol 13:855–857CrossRefPubMed Van den Heuvel-Eibrink MM, Pieters R (2012) Steroids and risk of osteonecrosis in ALL: take a break. Lancet Oncol 13:855–857CrossRefPubMed
Metadaten
Titel
Multicentric epidemiologic study on six thousand three hundred and ninety five cases of femoral head osteonecrosis in China
verfasst von
Liqiang Cui
Qianyu Zhuang
Jin Lin
Jin Jin
Ke Zhang
Li Cao
Jianhao Lin
Shigui Yan
Wanshou Guo
Wei He
Fuxing Pei
Yixin Zhou
Xisheng Weng
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 2/2016
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-3061-7

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