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The Multiplicative Effects of Individual Risk Factors in the Development of Osteonecrosis of the Femoral Head.
Lindsay, Sarah E; Kelly, Mackenzie; Smith, Spencer J; Kagan, Ryland P; Ramsey, Duncan C; Yoo, Jung U.
Afiliación
  • Lindsay SE; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon.
  • Kelly M; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon.
  • Smith SJ; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon.
  • Kagan RP; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon.
  • Ramsey DC; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon.
  • Yoo JU; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon.
J Arthroplasty ; 39(9S2): S246-S251, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38959988
ABSTRACT

BACKGROUND:

While individual risk factors, including chronic corticosteroid use, alcohol abuse, and smoking, are implicated in osteonecrosis of the femoral head (ONFH), the degree to which multiple risk factors increase risk is unknown. This study aimed to (1) identify the demographic characteristics of patients who have ONFH; (2) quantify the effects of individual risk factors on ONFH development; (3) quantify the effects of combined risk factors on ONFH development; and (4) determine the prognostic implications of combined risk factors on ONFH development.

METHODS:

This was a retrospective cohort study. A national insurance database was used to study a population of 2,612,383 adult patients who had a 10-year follow-up period. There were 10,233 patients identified who had a diagnosis of ONFH. We identified patients who had chronic corticosteroid use, tobacco use, and/or alcohol abuse and assessed the risk of developing ONFH over a 10-year period. Patients who had individual and multiple risk factors were grouped for comparison, and Chi-square analyses were performed.

RESULTS:

Higher proportions of patients who had each individual risk factor developed ONFH compared to proportions of patients who did not have risk factors. Patients who had combined risk factors were at greater risk of developing ONFH compared to patients who had no risk factors and those who had single risk factors. Combined risk factors demonstrated multiplicative effects on the development of ONFH tobacco-alcohol risk ratio (RR) 5.25, corticosteroid-alcohol RR 10.20, tobacco-corticosteroid RR 8.69, and corticosteroid-tobacco-alcohol RR 12.54. Patients who had combined risk factors developed ONFH at younger ages than those who had single risk factors. Kaplan-Meier curve analyses demonstrated worse 10-year hip survival in the setting of combined risk factors.

CONCLUSIONS:

Combined risk factors have a multiplicative effect on the risk of developing of atraumatic ONFH. Orthopaedic surgeons may care for at-risk individuals through modulation of risk factors. LEVEL OF EVIDENCE Retrospective Cohort Study, Level III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Necrosis de la Cabeza Femoral Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Necrosis de la Cabeza Femoral Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos