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

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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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Acknowledgments

All listed authors have each made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; participated in drafting the manuscript or revising it critically for content; and have approved the final version of the submitted manuscript.

Dr. Liqiang Cui, Dr. Qianyu Zhuang and Dr. Xisheng Weng accept responsibility for the integrity of the data analysis.

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedics, Peking Union Medical College Hospital, No.1 Shuai-fu-yuan, Wang-fu-jing, Beijing, 100730, China

      Liqiang Cui, Qianyu Zhuang, Jin Lin, Jin Jin & Xisheng Weng

    2. Department of Orthopaedics, Peking University Third Hospital, North Garden Rd No. 49, Haidian District, Beijing, 100191, China

      Ke Zhang

    3. Department of Orthopaedics, The First Teaching Hospital of Xinjiang Medical University, South Liyushan street No. 137, Wulumuqi, Xinjiang Province, 830054, China

      Li Cao

    4. Department of Orthopaedics, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People’s Republic of China

      Jianhao Lin

    5. Department of Orthopaedics, The First Affiliated Hospital of Zhejiang University, Qingchun street No. 79, Hangzhou, Zhejiang Province, 310003, China

      Shigui Yan

    6. Department of Orthopaedics, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Beijing, 100029, China

      Wanshou Guo

    7. Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, No. 16 Airport Street, Guangzhou, 510405, China

      Wei He

    8. Department of Orthopaedics, West China Hospital, Sichuan University, No. 37, Guoxue Street, Wuhou district, Chengdu, Sichuan, 610041, China

      Fuxing Pei

    9. Department of Orthopaedics, Beijing Jishuitan Hospital, No. 31 Eastern Xinjiekou Street, Xicheng district, Beijing, 100035, China

      Yixin Zhou

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    1. Liqiang Cui
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    2. Qianyu Zhuang
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    3. Jin Lin
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    Corresponding author

    Correspondence to Xisheng Weng.

    Additional information

    Liqiang Cui and Qianyu Zhuang contributed equally to this work.

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    Cui, L., Zhuang, Q., Lin, J. et al. Multicentric epidemiologic study on six thousand three hundred and ninety five cases of femoral head osteonecrosis in China. International Orthopaedics (SICOT) 40, 267–276 (2016). https://doi.org/10.1007/s00264-015-3061-7

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    • DOI: https://doi.org/10.1007/s00264-015-3061-7

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