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Clin Orthop Relat Res. 2010 Oct;468(10):2715-24. doi: 10.1007/s11999-010-1292-x. Epub 2010 Mar 12.

Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head.

Author information

1
Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. wakaba@med.osaka-cu.ac.jp

Abstract

BACKGROUND:

Although numerous studies describe the clinical characteristics of idiopathic osteonecrosis of the femoral head (ONFH) in specific study populations, these have not been confirmed in countrywide studies.

QUESTIONS/PURPOSES:

We therefore determined: (1) the annual number of patients seeking medical care and number of patients newly diagnosed; and (2) the distribution of the age and gender of the patients, potential causative factors, severity of the disease, and operative procedures performed.

PATIENTS AND METHODS:

We conducted a nationwide epidemiologic survey in 2005. The survey included all orthopaedic departments in Japan by stratified random sampling according to the number of beds.

RESULTS:

The number of patients who sought medical care for idiopathic ONFH during 2004 was estimated to be 11,400 (95% confidence interval, 10,100-12,800). We obtained clinical information from 1502 of these patients. The peak in age distribution occurred in the 40s. Potential causative factors were systemic steroid administration (51%) and habitual alcohol use (31%). Hip replacement was the most frequently performed procedure (65%). Among patients with a history of systemic steroid administration, systemic lupus erythematosus was reported most frequently (31%) as the underlying disease. Among patients younger than 40 years, steroid use was the most prominent potential causative factor (60%), and hip replacement frequently was performed (45%). A greater proportion of patients with no history of steroid or alcohol use was observed among patients 65 years or older (41%).

CONCLUSIONS:

In addition to the disease burden of idiopathic ONFH in Japan, our results confirmed the importance of developing preventive and treatment strategies, especially among the younger population.

LEVEL OF EVIDENCE:

Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

PMID:
20224959
PMCID:
PMC2939331
DOI:
10.1007/s11999-010-1292-x
[Indexed for MEDLINE]
Free PMC Article

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