Zhongxin Zhu1,2, Shaoguang Li1,2, Huan Yu1,2, Jiaxin Huang1,2, Peijian Tong3,4. 1. Zhejiang Chinese Medical University, 310053, Hangzhou, Zhejiang, China. 2. Institute of Orthopedics and Traumatology of Zhejiang Province, 310053, Hangzhou, Zhejiang, China. 3. Institute of Orthopedics and Traumatology of Zhejiang Province, 310053, Hangzhou, Zhejiang, China. tongpeijian@163.com. 4. Department of Orthopedic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, 310053, Hangzhou, Zhejiang, China. tongpeijian@163.com.
Abstract
OBJECTIVE: To evaluate the correlation between continuation of glucocorticoid (GC) treatment and risk of femoral head collapse in patients with glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) after hip-preserving interventions. METHODS: The cohort included patients with GIONFH who had received a hip-preserving intervention between 1 January 2014 and 1 April 2016. All hips were at the non-collapse stage. The independent variable and the dependent variable were postoperative GC use and femoral head collapse (≥3 mm), respectively. Multivariate Cox proportional hazards regression were performed to estimate the association of the variables after adjusting for other covariates. RESULTS: A total of 27 hips (24 patients) were included for the final data analysis of which 6 hips out of 18 developed femoral head collapse (≥3 mm) in patients who discontinued taking GC postoperatively and 6 hips out of 9 developed collapse (≥3 mm) in those requiring GC treatment postoperatively. In the fully adjusted Cox proportional hazards model, the risk of femoral head collapse (≥3 mm) was higher in participants requiring postoperative GC use than those not requiring GC (hazard ratio, HR 3.7, 95% confidence interval, CI 1.1-13.0). CONCLUSION: The results of this study demonstrated that patients with GIONFH who continued GC treatment postoperatively had a significantly increased risk of femoral head collapse (≥3 mm) compared to those who discontinued use of GC.
OBJECTIVE: To evaluate the correlation between continuation of glucocorticoid (GC) treatment and risk of femoral head collapse in patients with glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) after hip-preserving interventions. METHODS: The cohort included patients with GIONFH who had received a hip-preserving intervention between 1 January 2014 and 1 April 2016. All hips were at the non-collapse stage. The independent variable and the dependent variable were postoperative GC use and femoral head collapse (≥3 mm), respectively. Multivariate Cox proportional hazards regression were performed to estimate the association of the variables after adjusting for other covariates. RESULTS: A total of 27 hips (24 patients) were included for the final data analysis of which 6 hips out of 18 developed femoral head collapse (≥3 mm) in patients who discontinued taking GC postoperatively and 6 hips out of 9 developed collapse (≥3 mm) in those requiring GC treatment postoperatively. In the fully adjusted Cox proportional hazards model, the risk of femoral head collapse (≥3 mm) was higher in participants requiring postoperative GC use than those not requiring GC (hazard ratio, HR 3.7, 95% confidence interval, CI 1.1-13.0). CONCLUSION: The results of this study demonstrated that patients with GIONFH who continued GC treatment postoperatively had a significantly increased risk of femoral head collapse (≥3 mm) compared to those who discontinued use of GC.
Entities:
Keywords:
Adverse effects; Osteonecrosis; Outcome; Quality of life; Retrospective study
Authors: Michael A Mont; German A Marulanda; Lynne C Jones; Khaled J Saleh; Noah Gordon; David S Hungerford; Marvin E Steinberg Journal: J Bone Joint Surg Am Date: 2006-11 Impact factor: 5.284
Authors: Jun Ying; Pinger Wang; Quanwei Ding; Jie Shen; Regis J O'Keefe; Di Chen; Peijian Tong; Hongting Jin Journal: J Orthop Res Date: 2019-10-06 Impact factor: 3.494