Time elapsed from definitive diagnosis to surgery for osteonecrosis of the femoral head: a nationwide observational study in Japan.

Autor:	Nakamura J; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan njonedr@chiba-u.jp., Fukushima W; Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan., Ando W; Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.; Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan., Hagiwara S; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Kawarai Y; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Shiko Y; Biostatistics Section, Clinical Research Centre, Chiba University Hospital, Chiba, Japan., Kawasaki Y; Biostatistics Section, Clinical Research Centre, Chiba University Hospital, Chiba, Japan.; Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan., Sakai T; Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.; Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan., Ito K; Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.; Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan., Arishima Y; Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan., Chosa E; Department of Orthopaedic Surgery, Miyazaki University, Miyazaki, Japan., Fujimoto Y; Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan., Fujiwara K; Department of Orthopaedic Surgery, Okayama University, Okayama, Japan., Hasegawa Y; Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan., Hayashi S; Department of Orthopaedic Surgery, Kobe University, Kobe, Japan., Imagama T; Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan., Inaba Y; Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan., Ishibashi Y; Department of Orthopaedic Surgery, Hirosaki University, Hirosaki, Japan., Ishidou Y; Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan., Ito H; Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan., Ito H; Department of Orthopaedic Surgery, Asahikawa Medical University, Asahikawa, Japan., Ito J; Department of Orthopaedic Surgery, Yamagata University, Yamagata, Japan., Jinno T; Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Kabata T; Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan., Kaku N; Department of Orthopaedic Surgery, Oita University, Yufu, Japan., Kaneuji A; Department of Orthopaedic Surgery, Kanazawa Medical University, Kahoku-gun, Japan., Kishida S; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Kobayashi S; Department of Orthopaedic Surgery, Suwa Red Cross Hospital, Suwa, Japan., Komiya S; Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan., Kubo T; Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan., Majima T; Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan., Mashima N; Department of Orthopaedic Surgery, Ehime University, Toon, Japan., Mawatari M; Department of Orthopaedic Surgery, Saga University, Saga, Japan., Miki H; Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan., Miyatake K; Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Motomura G; Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan., Nagoya S; Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan., Nakamura H; Department of Orthopaedic Surgery, Osaka Metropolitan University, Osaka, Japan., Nakamura Y; Department of Orthopaedic Surgery, Hirosaki University, Hirosaki, Japan., Nakanishi R; Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan., Nakashima Y; Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan., Nakasone S; Department of Orthopaedic Surgery, Ryukyu University, Nakagami-gun, Japan., Nishii T; Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan., Nishiyama T; Department of Orthopaedic Surgery, Kobe University, Kobe, Japan., Ohta Y; Department of Orthopaedic Surgery, Osaka Metropolitan University, Osaka, Japan., Ohzono K; Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan., Osaki M; Department of Orthopaedic Surgery, Nagasaki University, Nagasaki, Japan., Sasaki K; Department of Orthopaedic Surgery, Yamagata University, Yamagata, Japan., Seki T; Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan.; Depatrment of Orthopedic Surgery, Aichi Medical University Medical Centre, Okazaki, Japan., Shishido T; Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan., Shoji T; Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan., Sudo A; Department of Orthopaedic Surgery, Mie University, Tsu, Japan., Takagi M; Department of Orthopaedic Surgery, Yamagata University, Yamagata, Japan., Takahashi D; Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan., Takao M; Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.; Department of Orthopaedic Surgery, Ehime University, Toon, Japan., Tanaka S; Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan., Tanaka T; Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan., Tetsunaga T; Department of Orthopaedic Surgery, Okayama University, Okayama, Japan., Ueshima K; Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan., Yamamoto K; Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan., Yamamoto T; Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.; Department of Orthopaedic Surgery, Fukuoka University, Fukuoka, Japan., Yamamoto Y; Department of Orthopaedic Surgery, Hirosaki University, Hirosaki, Japan., Yamasaki T; Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan., Yasunaga Y; Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan., Sugano N; Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Mar 29; Vol. 14 (3), pp. e082342. Date of Electronic Publication: 2024 Mar 29.
DOI:	10.1136/bmjopen-2023-082342
Abstrakt:	Objectives: This study documents the time elapsed from the diagnosis of osteonecrosis of the femoral head (ONFH) to surgery, exploring the factors that influence ONFH severity. Design: Retrospective observational study of a nationwide database. Setting: The Kaplan-Meier method with log-rank tests was applied to examine the period from definitive diagnosis of ONFH to surgery using any surgery as the end point. For bilateral cases, the date of the first surgery was the endpoint. Participants: This study included 2074 ONFH cases registered in 34 university hospitals and highly specialised hospitals of the multicentre sentinel monitoring system of the Japanese Investigation Committee between 1997 and 2018. Main Outcome Measure: The primary outcome was the time from diagnosis to surgery. The secondary outcome was the proportion of subjects remaining without surgery at 3, 6 and 9 months, and at 1, 2 and 5 years after diagnosis. Results: The median time to surgery was 9 months (IQR 4-22 months) after diagnosis of ONFH. The time to surgery was significantly shorter in the alcohol alone group and the combined corticosteroid and alcohol group than in the corticosteroid alone group (p=0.018 and p<0.001, respectively), in early stage ONFH with no or mild joint destruction (stages II and III, p<0.001), and with joint preserving surgery (p<0.001). The proportion without surgery was 75.8% at 3 months, 59.6% at 6 months, 48.2% at 9 months, 40.5% at 1 year, 22.2% at 2 years and 8.3% at 5 years. Conclusion: ONFH has been considered to be an intractable disease that often requires surgical treatment, but the fact that surgery was performed in more than half of the patients within 9 months from diagnosis suggests severe disease with a significant clinical impact. Trial Registration Number: Chiba University ID1049. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu