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International Orthopaedics

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14-09-2022 | Osteoarthrosis | Original Paper

Hip function in patients undergoing conservative treatment for osteonecrosis of the femoral head

Authors: Yusuke Osawa, Yasuhiko Takegami, Daisaku Kato, Masanori Okamoto, Hiroki Iida, Shiro Imagama

Published in: International Orthopaedics | Issue 1/2023

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.

Mont MA, Salem HS, Piuzzi NS et al (2020) Nontraumatic osteonecrosis of the femoral head: Where do we stand today?: a 5-year update. J Bone Joint Surg Am 102:1084–1099. https://doi.org/10.2106/JBJS.19.01271CrossRef

Hauzeur JP, Malaise M, de Maertelaer V (2016) A prospective cohort study of the clinical presentation of non-traumatic osteonecrosis of the femoral head: spine and knee symptoms as clinical presentation of hip osteonecrosis. Int Orthop 40:1347–1351. https://doi.org/10.1007/s00264-015-3079-xCrossRef

Osawa Y, Seki T, Takegami Y et al (2018) Do femoral head collapse and the contralateral condition affect patient-reported quality of life and referral pain in patients with osteonecrosis of the femoral head. Int Orthop 42:1463–1468. https://doi.org/10.1007/s00264-018-3867-1CrossRef

Issa K, Pivec R, Kapadia BH et al (2013) Osteonecrosis of the femoral head: the total hip replacement solution. Bone Joint J 95-B:46–50. https://doi.org/10.1302/0301-620X.95B11.32644CrossRef

Osawa Y, Seki T, Takegami Y et al (2018) Cementless total hip arthroplasty for osteonecrosis and osteoarthritis produce similar results at ten years follow-up when matched for age and gender. Int Orthop 42:1683–1688. https://doi.org/10.1007/s00264-018-3987-7CrossRef

Kim HS, Park JW, Ha JH et al (2022) Third-generation ceramic-on-ceramic total hip arthroplasty in patients with osteonecrosis of the femoral head: a 10- to 16-year follow-up study. J Bone Joint Surg Am 104:68–75. https://doi.org/10.2106/JBJS.20.00720CrossRef

Min BW, Cho CH, Son ES et al (2020) Highly cross-linked polyethylene in total hip arthroplasty in patients younger than 50 years with osteonecrosis of the femoral head: a minimum of 10 years of follow-up. J Arthroplasty 35:805–810. https://doi.org/10.1016/j.arth.2019.10.021CrossRef

Bergh C, Fenstad AM, Furnes O et al (2014) Increased risk of revision in patients with non-traumatic femoral head necrosis. Acta Orthop 85:11–17. https://doi.org/10.3109/17453674.2013.874927CrossRef

Tsukanaka M, Halvorsen V, Nordsletten L et al (2016) Implant survival and radiographic outcome of total hip replacement in patients less than 20 years old. Acta Orthop 87:479–484. https://doi.org/10.1080/17453674.2016.1212180CrossRef

10.

Nishii T, Sugano N, Ohzono K et al (2002) Progression and cessation of collapse in osteonecrosis of the femoral head. Clin Orthop Relat Res 400:149–157. https://doi.org/10.1097/00003086-200207000-00019CrossRef

11.

Osawa Y, Seki T, Takegami Y et al (2021) Collapse progression or cessation affects the natural history of contralateral osteonecrosis of the femoral head. J Arthroplasty 36:3839–3844. https://doi.org/10.1016/j.arth.2021.08.005CrossRef

12.

Sugano N, Atsumi T, Ohzono K et al (2002) The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci 7:601–605. https://doi.org/10.1007/s007760200108CrossRef

13.

Matsumoto T, Kaneuji A, Hiejima Y et al (2012) Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association. J Orthop Sci 17(1):25–38CrossRef

14.

Kubo Y, Motomura G, Ikemura S et al (2018) The effect of the anterior boundary of necrotic lesion on the occurrence of collapse in osteonecrosis of the femoral head. Int Orthop 42:1449–1455. https://doi.org/10.1007/s00264-018-3836-8CrossRef

15.

Iwasa M, Ando W, Uemura K et al (2022) Association between magnitude of femoral head collapse and quality of life in patients with osteonecrosis of the femoral head. Mod Rheumatol. https://doi.org/10.1093/mr/roac023CrossRef

16.

Mont MA, Zywiel MG, Marker DR et al (2010) The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg Am 92:2165–2170. https://doi.org/10.2106/JBJS.I.00575CrossRef

17.

Jo WL, Lee YK, Ha YC et al (2018) Delay of total hip arthroplasty to advanced stage worsens post-operative hip motion in patients with femoral head osteonecrosis. Int Orthop 42:1599–1603. https://doi.org/10.1007/s00264-018-3952-5CrossRef

18.

Takegami Y, Seki T, Osawa Y et al (2020) Does unilateral total hip arthroplasty improve pain and function in the non-operative hip joint? Eur J Orthop Surg Traumatol 30:1411–1416. https://doi.org/10.1007/s00590-020-02716-0CrossRef

Title: Hip function in patients undergoing conservative treatment for osteonecrosis of the femoral head
Authors: Yusuke Osawa
Yasuhiko Takegami
Daisaku Kato
Masanori Okamoto
Hiroki Iida
Shiro Imagama
Publication date: 14-09-2022
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Osteoarthrosis
Osteonecrosis of the Femoral Head
Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 1/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-022-05569-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hip function in patients undergoing conservative treatment for osteonecrosis of the femoral head

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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