A delphi-based model for prognosis of femoral head collapse in osteonecrosis: a multi-factorial approach

Autor: Tong-jie Yang, Shi-yi Sun, Lei Zhang, Xing-ping Zhang, Hai-jun He
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Orthopaedic Surgery and Research, Vol 19, Iss 1, Pp 1-14 (2024)
Druh dokumentu: article
ISSN: 1749-799X
DOI: 10.1186/s13018-024-05247-0
Popis: Abstract Background Osteonecrosis of the femoral head (ONFH) is a progressive and debilitating condition characterized by the death of bone tissue due to inadequate blood supply. Despite advances in diagnostic imaging and treatment strategies, predicting the risk of femoral head collapse remains a significant clinical challenge. This study seeks to address this gap by developing a robust prognostic model that integrates clinical, imaging, and laboratory data to improve early diagnosis and guide therapeutic decision-making. Methods We conducted a qualitative systematic review and employed the Delphi method to select key prognostic factors from clinical data, imaging findings, and laboratory indicators. The study included ONFH patients treated from January 2014 to December 2021. We used univariate and multivariate Cox regression analyses to develop a nomogram for predicting the risk of femoral head collapse. The model’s performance was evaluated using the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Results The study included 297 patients (454 hips) with ONFH. Key prognostic factors identified included pain presence (p
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