Cargando…
The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system
BACKGROUND: Core decompression (CD) is considered the most popular treatment method for patients with Association Research Circulation Osseous (ARCO) stage I-II osteonecrosis of the femoral head (ONFH). However, the definitive indication for CD is currently not well established. METHODS: This was a...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10061868/ https://www.ncbi.nlm.nih.gov/pubmed/36997998 http://dx.doi.org/10.1186/s12891-023-06321-0 |
_version_ | 1785017380630429696 |
---|---|
author | Wei, Congcong Yang, Meng Chu, Kun Huo, Jia Chen, Xiao Liu, Bo Li, Huijie |
author_facet | Wei, Congcong Yang, Meng Chu, Kun Huo, Jia Chen, Xiao Liu, Bo Li, Huijie |
author_sort | Wei, Congcong |
collection | PubMed |
description | BACKGROUND: Core decompression (CD) is considered the most popular treatment method for patients with Association Research Circulation Osseous (ARCO) stage I-II osteonecrosis of the femoral head (ONFH). However, the definitive indication for CD is currently not well established. METHODS: This was a retrospective cohort study. Patients who were diagnosed with ARCO stage I-II ONFH and who underwent CD were included. According to the prognosis, the patients were divided into two groups: collapse of the femoral head after CD and noncollapse of the femoral head. Independent risk factors for the failure of CD treatment were identified. Subsequently, a new scoring system that included all these risk factors was built to help estimate the individual risk of CD failure in patients who were planning to undergo CD. RESULTS: The study included 1537 hips after decompression surgery. The overall failure rate of CD surgery was 52.44%. Seven independent prognostic factors for failed CD surgery were identified, such as male sex (HR = 75.449; 95% confidence interval (CI), 42.863-132.807), Aetiology (Idiopathic HR = 2.762; 95% CI, 2.016–3.788, Steroid-induced HR = 2.543; 95% CI, 1.852–3.685), if the patient had a seated occupation (HR = 3.937; 95% CI, 2.712–5.716), age (HR = 1.045; 95% CI, 1.032–1.058), haemoglobin level (HR = 0.909; 95% CI, 0.897–0.922), disease duration (HR = 1.217; 95% CI, 1.169–1.267) and the combined necrosis angle (HR = 1.025; 95% CI, 1.022–1.028). The final scoring system included these seven risk factors, and the area under the curve of this scoring system was 0.935 (95% confidential interval = 0.922–0.948). CONCLUSION: This new scoring system might provide evidence-based medical proof for determining whether a patient with ARCO stage I - II ONFH might benefit from CD surgery. This scoring system is crucial for making clinical decisions. Consequently, this scoring system is recommended before CD surgery, which could help determine the potential prognosis of patients. |
format | Online Article Text |
id | pubmed-10061868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-100618682023-03-31 The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system Wei, Congcong Yang, Meng Chu, Kun Huo, Jia Chen, Xiao Liu, Bo Li, Huijie BMC Musculoskelet Disord Research BACKGROUND: Core decompression (CD) is considered the most popular treatment method for patients with Association Research Circulation Osseous (ARCO) stage I-II osteonecrosis of the femoral head (ONFH). However, the definitive indication for CD is currently not well established. METHODS: This was a retrospective cohort study. Patients who were diagnosed with ARCO stage I-II ONFH and who underwent CD were included. According to the prognosis, the patients were divided into two groups: collapse of the femoral head after CD and noncollapse of the femoral head. Independent risk factors for the failure of CD treatment were identified. Subsequently, a new scoring system that included all these risk factors was built to help estimate the individual risk of CD failure in patients who were planning to undergo CD. RESULTS: The study included 1537 hips after decompression surgery. The overall failure rate of CD surgery was 52.44%. Seven independent prognostic factors for failed CD surgery were identified, such as male sex (HR = 75.449; 95% confidence interval (CI), 42.863-132.807), Aetiology (Idiopathic HR = 2.762; 95% CI, 2.016–3.788, Steroid-induced HR = 2.543; 95% CI, 1.852–3.685), if the patient had a seated occupation (HR = 3.937; 95% CI, 2.712–5.716), age (HR = 1.045; 95% CI, 1.032–1.058), haemoglobin level (HR = 0.909; 95% CI, 0.897–0.922), disease duration (HR = 1.217; 95% CI, 1.169–1.267) and the combined necrosis angle (HR = 1.025; 95% CI, 1.022–1.028). The final scoring system included these seven risk factors, and the area under the curve of this scoring system was 0.935 (95% confidential interval = 0.922–0.948). CONCLUSION: This new scoring system might provide evidence-based medical proof for determining whether a patient with ARCO stage I - II ONFH might benefit from CD surgery. This scoring system is crucial for making clinical decisions. Consequently, this scoring system is recommended before CD surgery, which could help determine the potential prognosis of patients. BioMed Central 2023-03-30 /pmc/articles/PMC10061868/ /pubmed/36997998 http://dx.doi.org/10.1186/s12891-023-06321-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Wei, Congcong Yang, Meng Chu, Kun Huo, Jia Chen, Xiao Liu, Bo Li, Huijie The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system |
title | The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system |
title_full | The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system |
title_fullStr | The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system |
title_full_unstemmed | The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system |
title_short | The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system |
title_sort | indications for core decompression surgery in patients with arco stage i-ii osteonecrosis of the femoral head: a new, comprehensive prediction system |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10061868/ https://www.ncbi.nlm.nih.gov/pubmed/36997998 http://dx.doi.org/10.1186/s12891-023-06321-0 |
work_keys_str_mv | AT weicongcong theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT yangmeng theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT chukun theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT huojia theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT chenxiao theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT liubo theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT lihuijie theindicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT weicongcong indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT yangmeng indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT chukun indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT huojia indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT chenxiao indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT liubo indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem AT lihuijie indicationsforcoredecompressionsurgeryinpatientswitharcostageiiiosteonecrosisofthefemoralheadanewcomprehensivepredictionsystem |