The incidence of conversion to hip arthroplasty after core decompression.

IF 4.9 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2025-03-01 DOI:10.1302/0301-620X.107B3.BJJ-2024-0815.R1

Hao-Che Tang, Daphne I Ling, Shu-Han Hsu, Chieh-An Chuang, Kai-Lan Hsu, Li-Jung E Ku

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引用次数: 0

Abstract

Aims: Core decompression is a commonly performed procedure to treat osteonecrosis of the femoral head (ONFH) prior to femoral head collapse. The aim of the study was to identify the incidence of hip arthroplasty after core decompression and the potential risk factors for conversion through a nationwide population-based study.

Methods: Patients who received core decompression for ONFH between 1 January 2009 and 31 December 2018 and were followed up until 31 December 2019 (mean 33 months (0.2 to 132)) were retrieved from Taiwan's National Health Insurance claims database. A total of 2,918 patients were identified and included in the study. The mean age at the time of core decompression was 46 years (SD 12.5), with a male-to-female ratio of 7:3. The first total hip arthroplasty or hip hemiarthroplasty after the index core decompression was considered as the outcome of conversion to hip arthroplasty. For the analysis of conversion risk, patients' demographic characteristics, economic status, comorbidities, and data on the type of hospital and surgeons' experience were included.

Results: Overall, 20.05% of patients received a hip arthroplasty within six months following core decompression, with the incidence rising to 60.6% by five years and 66.4% by ten years. Multivariable analysis revealed that patients aged over 40 years (HR 1.18 (95% CI 1.07 to 1.30); p = 0.002), who had a history of alcohol abuse (HR 1.57 (95% CI 1.22 to 2.02); p < 0.001), and had their procedures performed at district-level hospitals (HR 1.13 (95% CI 1.00 to 1.26; p = 0.044), were at increased risk of conversion to hip arthroplasty following core decompression.

Conclusion: The five- and ten-year cumulative incidence of conversion to hip arthroplasty after core decompression was 60.6% and 66.4%, respectively. Significant risk factors for conversion to hip arthroplasty included age over 40 years, history of alcohol abuse, and procedures performed at district hospitals.

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目的：核心减压术是在股骨头塌陷前治疗股骨头坏死（ONFH）的常用手术。该研究旨在通过一项全国范围内的人群研究，确定核心减压术后髋关节置换术的发生率以及转为髋关节置换术的潜在风险因素：方法：从台湾国民健康保险理赔数据库中检索2009年1月1日至2018年12月31日期间因ONFH接受核心减压术并随访至2019年12月31日（平均33个月（0.2至132个月））的患者。共有 2918 名患者被确认并纳入研究。核心减压时的平均年龄为 46 岁（标准差 12.5），男女比例为 7:3。指标核心减压后的首次全髋关节置换术或髋关节半置换术被视为转为髋关节置换术的结果。为了分析转为髋关节置换术的风险，还纳入了患者的人口统计学特征、经济状况、合并症以及医院类型和外科医生经验等数据：总体而言，20.05%的患者在核心减压术后六个月内接受了髋关节置换术，五年后这一比例上升到60.6%，十年后上升到66.4%。多变量分析显示，年龄超过40岁（HR 1.18 (95% CI 1.07 to 1.30); p = 0.002）、有酗酒史（HR 1.57 (95% CI 1.22 to 2.02); p < 0.001）、在地区级医院接受手术（HR 1.13 (95% CI 1.00 to 1.26; p = 0.044）的患者在核心减压术后转为髋关节置换术的风险更高：结论：核心减压术后五年和十年转为髋关节置换术的累积发生率分别为60.6%和66.4%。转为髋关节置换术的重要风险因素包括年龄超过40岁、酗酒史以及在地区医院进行的手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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