ArticleBMC musculoskeletal disorders2023
The indications for core decompression surgery in patients with ARCO stage I-II osteonecrosis of the femoral head: a new, comprehensive prediction system.
Article in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Comparison of clinical efficacy of robot-assisted and freehand core decompression in the treatment of osteonecrosis of the femoral head: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2024Pooled it
- The Effect of Systemic Steroid Use on the Success of Core Decompression in Non-Traumatic Early-Stage Femoral Head Osteonecrosis.Sisli Etfal Hastanesi tip bulteni · 2026Article
- The fate of bone marrow edema after core decompression and bone marrow aspiration concentrate grafting for the hip.BMC musculoskeletal disorders · 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
- Arthroscopic Core Decompression With Allogeneic Bone Grafting for Femoral Head Osteonecrosis and Femoral Head-Neck Junction Cysts.Arthroscopy techniques · 2025Article
- Injectable hydrogel regulates immune infiltration through physical and chemical synergy in the treatment of steroid-induced osteonecrosis of the femoral head.Materials today. Bio · 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
- Healing beyond bone: a qualitative study of the core decompression experience of physically active patients with stage II hip avascular necrosis.Journal of orthopaedic surgery and research · 2025Article
- A radiomics and deep learning nomogram developed and validated for predicting no-collapse survival in patients with osteonecrosis after multiple drilling.BMC medical informatics and decision making · 2025Article
- Precollapse femoral head avascular necrosis after combined surgical-medical management.Bioinformation · 2025Article
- Outcomes of single-incision-augmented core decompression using trochanteric autograft in osteonecrosis of femoral head-a mean 5-year follow-up study.Journal of hip preservation surgery · 2024Article
- Femoral Head Core Decompressions: Characterization of Subsequent Conversion to Total Hip Arthroplasty and Related Complications.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
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7 authors at 3 institutions in 1 country.
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Abstract
backgroundCore decompression (CD) is considered the most popular treatment method for patients with Association Research Circulation Osseous (ARCO) stage I-II osteonecrosis of the femoral head (ONFH). However, the definitive indication for CD is currently not well established.
methodsThis was a retrospective cohort study. Patients who were diagnosed with ARCO stage I-II ONFH and who underwent CD were included. According to the prognosis, the patients were divided into two groups: collapse of the femoral head after CD and noncollapse of the femoral head. Independent risk factors for the failure of CD treatment were identified. Subsequently, a new scoring system that included all these risk factors was built to help estimate the individual risk of CD failure in patients who were planning to undergo CD.
resultsThe study included 1537 hips after decompression surgery. The overall failure rate of CD surgery was 52.44%. Seven independent prognostic factors for failed CD surgery were identified, such as male sex (HR = 75.449; 95% confidence interval (CI), 42.863-132.807), Aetiology (Idiopathic HR = 2.762; 95% CI, 2.016-3.788, Steroid-induced HR = 2.543; 95% CI, 1.852-3.685), if the patient had a seated occupation (HR = 3.937; 95% CI, 2.712-5.716), age (HR = 1.045; 95% CI, 1.032-1.058), haemoglobin level (HR = 0.909; 95% CI, 0.897-0.922), disease duration (HR = 1.217; 95% CI, 1.169-1.267) and the combined necrosis angle (HR = 1.025; 95% CI, 1.022-1.028). The final scoring system included these seven risk factors, and the area under the curve of this scoring system was 0.935 (95% confidential interval = 0.922-0.948).
conclusionThis new scoring system might provide evidence-based medical proof for determining whether a patient with ARCO stage I - II ONFH might benefit from CD surgery. This scoring system is crucial for making clinical decisions. Consequently, this scoring system is recommended before CD surgery, which could help determine the potential prognosis of patients.
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