Shihua Gao1, Liang Mo1, Kaishen Cai1, Wei He2,3, Ziqi Li2,3. 1. Guangzhou University of Chinese Medicine, Guangzhou, China. 2. Traumatology and Orthopedics Institute, Guangzhou University of Chinese Medicine, Guangzhou, China. 3. The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
Abstract
Objective: To identify risk factors of failure after Non-Vascularized Bone Grafting (NVBG) in osteonecrosis patients, establish and validate a nomogram predictive model of hip survival after NVBG. Methods: Data on ONFH patients undergoing NVBG at our institution between 2010 and 2017 were retrospectively collected. Preoperative risk factors potentially associated with failure after NVBG were assessed by univariate Cox regression analyses. A predictive nomogram was developed based on multivariate Cox regression model. The performance of the nomogram model was evaluated by C statistic. Subjects were stratified according to total points calculated from the nomogram and Kaplan-Meier curves were plotted to further evaluate the discrimination of the model. The model was also internally validated through calibration curves. Results: The overall 2-year and 5-year hip survival percentages were 91.8 and 84.6%, respectively. Age, etiology, Association Research Circulation Osseous stage and range of necrotic lesion were independent risk factors of failure after NVBG. The C statistic of the nomogram model established with these predictors was 0.77 and Kaplan-Meier curves of the tertiles showed satisfactory discrimination of the model. Internal validation by calibration curves indicated favorable consistency between actual and predicted hip survival rate. Conclusion: This predictive model may be a practical tool for patient selection of NVBG. However, future studies are still needed to externally validate this model.
Objective: To identify risk factors of failure after Non-Vascularized Bone Grafting (NVBG) in osteonecrosis patients, establish and validate a nomogram predictive model of hip survival after NVBG. Methods: Data on ONFH patients undergoing NVBG at our institution between 2010 and 2017 were retrospectively collected. Preoperative risk factors potentially associated with failure after NVBG were assessed by univariate Cox regression analyses. A predictive nomogram was developed based on multivariate Cox regression model. The performance of the nomogram model was evaluated by C statistic. Subjects were stratified according to total points calculated from the nomogram and Kaplan-Meier curves were plotted to further evaluate the discrimination of the model. The model was also internally validated through calibration curves. Results: The overall 2-year and 5-year hip survival percentages were 91.8 and 84.6%, respectively. Age, etiology, Association Research Circulation Osseous stage and range of necrotic lesion were independent risk factors of failure after NVBG. The C statistic of the nomogram model established with these predictors was 0.77 and Kaplan-Meier curves of the tertiles showed satisfactory discrimination of the model. Internal validation by calibration curves indicated favorable consistency between actual and predicted hip survival rate. Conclusion: This predictive model may be a practical tool for patient selection of NVBG. However, future studies are still needed to externally validate this model.
Authors: Assem A Sultan; Anton Khlopas; Peter Surace; Linsen T Samuel; Mhamd Faour; Nipun Sodhi; Viktor E Krebs; Kim L Stearns; Robert M Molloy; Michael A Mont Journal: Int Orthop Date: 2018-07-23 Impact factor: 3.075
Authors: Byung-Ho Yoon; Michael A Mont; Kyung-Hoi Koo; Chung-Hwan Chen; Edward Y Cheng; Quanjun Cui; Wolf Drescher; Valerie Gangji; Stuart B Goodman; Yong-Chan Ha; Philippe Hernigou; Marc W Hungerford; Richard Iorio; Woo-Lam Jo; Lynne C Jones; Vikas Khanduja; Harry K W Kim; Shin-Yoon Kim; Tae-Young Kim; Hee Young Lee; Mel S Lee; Young-Kyun Lee; Yun Jong Lee; Junichi Nakamura; Javad Parvizi; Takashi Sakai; Nobuhiko Sugano; Masaki Takao; Takuaki Yamamoto; De-Wei Zhao Journal: J Arthroplasty Date: 2019-11-27 Impact factor: 4.757