ArticleBone & joint research2019
Classification of osteonecrosis of the femoral head: Who should have surgery?
Article in Bone & joint research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.
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Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- A delphi-based model for prognosis of femoral head collapse in osteonecrosis: a multi-factorial approach.Journal of orthopaedic surgery and research · 2024Pooled it
- Arthroscopic assisted versus open core decompression for osteonecrosis of the femoral head: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Impact of Preoperative Non-Collapse and Collapse Durations on Total Hip Arthroplasty Outcomes in Nontraumatic Osteonecrosis of the Femoral Head.Orthopaedic surgery · 2026Article
- Automatic diagnosis of osteonecrosis of the femoral head and segmentation of necrotic regions using deep learning at computed tomography: a real-world multicenter study.BMC musculoskeletal disorders · 2026Article
- Which trajectory should we choose? - Defining safe entry-target pathways and underlying femoral morphology for bone marrow injection in osteonecrosis of the femoral head.Regenerative therapy · 2026Article
- Safety, Feasibility, and Preliminary Efficacy of Allogeneic MSCs to Treat Advanced Femoral Head Osteonecrosis (ALOFEM): A Pilot Study in Young Onco-Hematological Patients.Stem cells international · 2026Article
- Outcome Assessment of Cementless Total Hip Arthroplasty in Patients with Late-stage Avascular Necrosis of the Femoral Head in Vietnam, 2011 - 2021.Orthopedic reviews · 2026Article
- Clinical, imaging, and histopathological characteristics of Vietnamese patients with late-stage avascular necrosis of the femoral head.BMC musculoskeletal disorders · 2025Article
- An Introspection on Vascularized bone transfers for Avascular Necrosis of Bones of Femoral Head and Scaphoid.Journal of orthopaedic case reports · 2025Article
- Distribution of early- versus late-stage ONFH in core decompression cases at a tertiary center: does presenting symptomatology affect conversion to total hip replacement?Journal of orthopaedic surgery and research · 2025Article
- Cystic lesions in osteoarthritis and osteonecrosis of the femoral head : a comparative analysis of 3D distribution, microstructure, and histology.Bone & joint research · 2025Article
- [Atraumatic necrosis of the femoral head].Orthopadie (Heidelberg, Germany) · 2025Review
- Hyperbaric oxygen therapy is effective and safe for femoral head osteonecrosis: a prospective midterm outcome study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Observational
- Variability in the classification, management, and outcome reporting for avascular necrosis of the femoral head: A systematic review.Journal of orthopaedics · 2025Review
- X-ray based radiomics machine learning models for predicting collapse of early-stage osteonecrosis of femoral head.Scientific reports · 2025Article
- National and regional trend over time in the prevalence of osteonecrosis of the femoral head among military draft-eligible males in South Korea: an analysis of a nationwide database from 2013 to 2022.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Relationship between anterior or posterior femoral head necrosis and collapse based on MRI-defined key necrotic layer sets.Journal of orthopaedic surgery and research · 2025Article
- Computer-aided diagnosis for China-Japan Friendship Hospital classification of necrotic femurs using statistical shape and appearance model based on CT scans.Medical & biological engineering & computing · 2025Article
- A nomogram for predicting contralateral femoral head collapse after unilateral replacement of bilateral femoral head necrosis.Scientific reports · 2025Article
- Discrepancy between radiography and magnetic resonance imaging in Japanese Investigation Committee classification type C osteonecrosis of the femoral head.International orthopaedics · 2025Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesUsing a simple classification method, we aimed to estimate the collapse rate due to osteonecrosis of the femoral head (ONFH) in order to develop treatment guidelines for joint-preserving surgeries.
methodsWe retrospectively analyzed 505 hips from 310 patients (141 men, 169 women; mean age 45.5 years (sd 14.9; 15 to 86)) diagnosed with ONFH and classified them using the Japanese Investigation Committee (JIC) classification. The JIC system includes four visualized types based on the location and size of osteonecrotic lesions on weightbearing surfaces (types A, B, C1, and C2) and the stage of ONFH. The collapse rate due to ONFH was calculated using Kaplan-Meier survival analysis, with radiological collapse/arthroplasty as endpoints.
resultsBilateral cases accounted for 390 hips, while unilateral cases accounted for 115. According to the JIC types, 21 hips were type A, 34 were type B, 173 were type C1, and 277 were type C2. At initial diagnosis, 238/505 hips (47.0%) had already collapsed. Further, the cumulative survival rate was analyzed in 212 precollapsed hips, and the two-year and five-year collapse rates were found to be 0% and 0%, 7.9% and 7.9%, 23.2% and 36.6%, and 57.8% and 84.8% for types A, B, C1, and C2, respectively.
conclusionType A ONFH needs no further treatment, but precollapse type C2 ONFH warrants immediate treatment with joint-preserving surgery. Considering the high collapse rate, our study results justify the importance of early diagnosis and intervention in asymptomatic patients with type C2 ONFH.
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