ArticleArthroplasty (London, England)2023
Increasing trend toward joint-preserving procedures for hip osteonecrosis in the United States from 2010 to 2019.
Article in Arthroplasty (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Patient-facing materials for hip and knee preservation surgery are written well above recommended reading level.Journal of hip preservation surgery · 2026Article
- Biomechanical comparative analysis of multiple small diameter fan-shaped and parallel core decompression for early osteonecrosis of the femoral head.Frontiers in bioengineering and biotechnology · 2026Article
- Comparative effectiveness of bone grafting vs. total hip arthroplasty in non-traumatic osteonecrosis of femoral head: a 5-year follow-up study with patient-reported outcomes.BMC musculoskeletal disorders · 2025Article
- Knowledge mapping of core decompression in osteonecrosis of the femoral head: a bibliometric analysis.Annals of medicine and surgery (2012) · 2025Review
- Hip joint-preserving strategies for treating osteonecrosis of the femoral head: From nonoperative to operative procedures.Journal of orthopaedic translation · 2025Review
- Unexpected positive cultures in conversion hip and knee arthroplasty.International orthopaedics · 2024Article
- Impact of Surgeon Volume on Perioperative Complications and Survival to Total Hip Arthroplasty Following Femoral Head Core Decompression.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- Systematic analysis of hip-preserving treatment for early osteonecrosis of the femoral head from the perspective of bibliometrics (2010-2023).Journal of orthopaedic surgery and research · 2023Article
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe incidence of osteonecrosis of the femoral head is estimated at about 10 to 20,000 patients annually, and, when left untreated, 80% or more of cases progress to femoral head collapse. A series of joint-preserving procedures have been developed to prevent/delay the need for hip arthroplasty. The aim of this study was to provide a five-year update: (1) evaluating temporal trends of arthroplasty vs. joint-preservation techniques such as core decompression, bone grafting, osteotomies, and arthroscopy; (2) determining proportions of procedures in patients aged less than vs. over 50 years; and (3) quantifying rates of specific operative techniques.
methodsA total of 10,334 patients diagnosed with osteonecrosis of the femoral head and having received hip surgery were identified from a nationwide database between 1 January 2010 and 31 December 2019, by using the International Classification of Disease, the Ninth/Tenth revision (ICD-9/10) codes. The percentage of patients managed by each operative procedure was calculated annually. To identify trends, patients were grouped by age under/over 50 years and divided into a joint-preserving and a non-joint-preserving (arthroplasty) group. Chi-squared tests were performed to compare the total number of procedures per year.
resultsRates of arthroplasty far exceeded those for joint-preserving procedures. However, from 2015 to 2019, significantly more joint-preserving procedures were performed than in 2010 to 2014 (4.3% vs. 3.0%, P < 0.001). Significantly more joint-preserving procedures were performed in patients aged < 50 years relative to those ≥ 50 years (7.56% vs. 1.86%, P < 0.001). Overall, total hip arthroplasty was the most common procedure (9,814; 94.97%) relative to core decompression (331; 3.20%), hemiarthroplasty/resurfacing (102; 0.99%), bone grafting (48; 0.46%), and osteotomy (5; 0.05%).
conclusionManagement of patients who have osteonecrosis of the femoral head continues to be predominantly arthroplasty procedures, specifically, total hip arthroplasty. Our findings suggest a small, but significant trend toward increased joint-preserving procedures, especially in patients under 50 years. In particular, the proportion of patients receiving core decompression has increased significantly from 2015 to 2019 relative to prior years.
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