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. 2024 Aug;48(8):2033-2040.
doi: 10.1007/s00264-024-06221-5. Epub 2024 May 28.

Factors related to collapse progression in Japanese Investigation Committee classification type B osteonecrosis of the femoral head

Hiroaki Ido  1 , Yusuke Osawa  2 , Yasuhiko Takegami  1 , Funahashi Hiroto  1 , Yuto Ozawa  1 , Shiro Imagama  1
Affiliations

Factors related to collapse progression in Japanese Investigation Committee classification type B osteonecrosis of the femoral head

Hiroaki Ido et al. Int Orthop. 2024 Aug.

Abstract

Purpose: This study aimed to identify factors related to collapse progression in Japanese Investigation Committee classification type B osteonecrosis of the femoral head (ONFH) and to identify patients who would benefit from surgical treatment.

Methods: This study included 41 patients (56 hips) with type B ONFH with a minimum follow-up of three years. Based on a ≥ 3 mm collapse progression in ONFH, we categorised patients into two groups: collapse progression and no collapse progression. Sagittal and coronal computed tomography images were used to measure the necrotic region relative to the intact femoral head diameter. The ratios of the necrotic regions of transverse and vertical diameter in coronal and sagittal images are defined as mediolateral transverse and mediolateral vertical, anteroposterior transverse and anteroposterior vertical, respectively. Demographic data and these imaging findings were compared between the two groups. We established a cut-off value for predicting collapse progression through receiver operating characteristic analysis and determined survival rates.

Results: Type B ONFH had a 17.8% collapse progression rate. The mediolateral transverse, mediolateral vertical, anteroposterior transverse, and anteroposterior vertical were significantly higher in the collapse progression group (P < 0.01). Mediolateral transverse was an independent risk factor of collapse progression (hazard ratio, 1.27; 95% confidence interval, 1.03-1.57; P = 0.03), with an optimal cut-off of 45.6%. The 5-year survival rates with collapse progression as the endpoints were 57.0 and 94.9% in the mediolateral transverse of ≥ 45.6 and < 45.6%, respectively.

Conclusion: A mediolateral transverse of ≥ 45.6% predicts collapse progression in patients with type B ONFH.

Keywords: Collapse progression; Joint-preserving procedure; Mediolateral transverse; Osteonecrosis of the femoral head; Prognosis.

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References

    1. Mankin HJ (1992) Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 326:1473–1479 - DOI - PubMed
    1. Arbab D, König DP (2016) Atraumatic femoral head necrosis in adults. Dtsch Arztebl Int 113:31–38 - PubMed - PMC
    1. 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(7):1463–1468 - DOI - PubMed
    1. 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 - DOI - PubMed
    1. 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 - DOI - PubMed