ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019
Epidemiology of osteonecrosis among older adults in Sweden.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Evidence-Supported HBO Therapy in Femoral Head Necrosis: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Hypoparathyroidism and Avascular Necrosis of the Hip Joint: A Case Report.Clinical case reports · 2026Article
- Osteonecrosis Research in Orthopedics and Traumatology: A Global Bibliometric Analysis of Publication Trends, Key Contributors, and Thematic Evolution.Orthopaedic surgery · 2026Article
- Article
- Immunomodulatory Mechanisms of Rehmanniae Radix Praeparata-Achyranthes Root-Chinese Angelica Root Combination in Nontraumatic Osteonecrosis of the Femoral Head: A Comprehensive Network Pharmacology and Molecular Docking Study Focusing on Immunological Pathways.Mediators of inflammation · 2025Article
- Plasma SQSTM1/p62 act as a biomarker for steroid-induced osteonecrosis of the femoral head.Scientific reports · 2024Article
- Oral Corticosteroids for Skin Disease in the Older Population: Minimizing Potential Adverse Effects.Drugs & aging · 2024Review
- Osteonecrosis of acetabulum following total hip arthroplasty: A case report and literature review.Clinical case reports · 2024Article
- A Comparative Analysis of Osteochondritis Dissecans and Avascular Necrosis: A Comprehensive Review.Journal of clinical medicine · 2024Review
- Relative frequency of avascular necrosis of the hip as indication for primary Total Hip Arthroplasty in the USA vs. India.Journal of orthopaedics · 2023Article
- Intraosseous Tibial Resuscitation After a Total Knee Arthroplasty Leading to Osteonecrosis and Loosening of the Tibial Component.Arthroplasty today · 2023Article
- Cementless femoral neck endoprosthesis SPIRON in men in aspects of clinical status and quality of life in an average 7-year follow-up.BMC musculoskeletal disorders · 2022Article
- [Drug-induced osteopathy in rheumatology].Zeitschrift fur Rheumatologie · 2022Review
- Steroid-induced osteonecrosis.Journal of translational autoimmunity · 2022Review
- The Emerging Role of MicroRNAs in Bone Diseases and Their Therapeutic Potential.Molecules (Basel, Switzerland) · 2021Review
- Glucocorticoid-induced osteonecrosis in systemic lupus erythematosus patients.Clinical and translational medicine · 2021Review
- Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?: A 5-Year Update.The Journal of bone and joint surgery. American volume · 2020Review
- Destructive Osteonecrosis of the Femoral Head After a Single Intra-Articular Corticosteroid Injection: A Report of Two Cases.International journal of surgery case reports · 2020Article
- Psychological distress and health-related quality of life in patients with bone marrow edema syndrome.Annals of translational medicine · 2019Article
- Relative frequency of primary total hip arthroplasty for avascular necrosis in the United States as compared to a regional center: A data review.Journal of orthopaedicsArticle
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Authors and funding
3 authors at 1 institution in 2 countries.
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Abstract
This study estimated the incidence of osteonecrosis in a Swedish, nationwide cohort of older adults. Osteonecrosis was approximately 10 times more common than in previous studies. The strongest risk factors were dialysis, hip fracture, osteomyelitis, and organ transplantation, but only hip fractures could have contributed substantially to the disease burden.
introductionThe aim of this study was to estimate the incidence of osteonecrosis in a Swedish, nationwide cohort of older adults and in a large number of risk groups in that cohort.
methodsIn this retrospective cohort study, we included everyone who was aged 50 years or older and who was living in Sweden on 31 December 2005. We used Swedish national databases to collect data about prescription medication use, diagnosed medical conditions, and performed medical and surgical procedures. The study outcome was diagnosis of primary or secondary osteonecrosis at any skeletal site. The strength of risk factors was assessed using age- and sex-standardized incidence ratios (SIRs).
resultsThe study cohort comprised 3,338,463 adults. The 10-year risk of osteonecrosis was 0.4% (n = 13,425), and the incidence rate was 4.7 cases/10000 person-years (95% confidence interval [CI], 4.6 to 4.7 cases). The strongest risk factors for osteonecrosis were hip fracture (SIR, 7.98; 95% CI, 7.69-8.27), solid organ transplantation (SIR, 7.14; 95% CI, 5.59-8.99), dialysis (SIR, 6.65; 95% CI, 5.62-7.81), and osteomyelitis (SIR, 6.43; 95% CI, 5.70-7.23). A history of hip fracture was present in 21.7% of cases of osteonecrosis, but osteomyelitis, dialysis, and solid organ transplantation were present in only 0.5 to 2% of cases.
conclusionsOsteonecrosis was approximately 10 times more common than a small number of previous population-based studies have suggested. The strongest risk factors for osteonecrosis were dialysis, hip fracture, osteomyelitis, and solid organ transplantation, but only hip fractures could have contributed substantially to the disease burden.
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