Abstract
BackgroundCore decompression is a common surgical technique to treat osteonecrosis of the femoral head. The aim of this study is to evaluate the effect of the parameters “age” and “sex” on the outcome of this type of treatment.MethodsA prospective cohort study was performed. Eighty-six osteonecrotic hips with a mean follow-up of 32.5 months (± 24.8) after advanced core decompression were analysed regarding age- and sex-dependent treatment failure. Additionally, the modified Harris Hip Score and Numeric Rating Scale were compared regarding the parameters age and sex.ResultsThe mean hip survival of the male participants was 51.3 months (39.4% treatment failure), whereas females presented a longer, thus not significant, mean survival of 61.4 months (30% therapy failure; p = 0.48). The further evaluation revealed significantly better survival in the patients aged < 40 years (mean survival 66.09 months, 16% treatment failure) in comparison to those aged ≥ 40 years (mean survival 50.14 months, 46% therapy failure; p = 0.03). The modified Harris Hip Score and Numeric Rating Scale results of patients whose treatment did not fail during the study period were similar, irrespective of the patient’s sex or age.ConclusionsThe study shows that the number of therapy failures is significantly higher in older patients, with 40 years of age marking the borderline. Patients’ sex does not seem to affect the outcome of treatment, and postoperative clinical scores appear to be identical with individuals not affected by therapy failure. Since age and sex are unalterable parameters, the study helps to provide valuable predictions regarding the chances of long-term hip survival after treatment of osteonecrosis.
Highlights
Core decompression is a common surgical technique to treat osteonecrosis of the femoral head
Osteonecrosis of the femoral head (ONFH) is a pathological condition of the hip joint characterized by impaired blood supply which induces progressing structural instability
As ONFH harbours the severe risk of irreversible damage to the affected hip, it is essential that treatment should
Summary
Core decompression is a common surgical technique to treat osteonecrosis of the femoral head. Osteonecrosis of the femoral head (ONFH) is a pathological condition of the hip joint characterized by impaired blood supply which induces progressing structural instability. Non-surgical options have been described for treatment of early-stage ONFH that is often characterized by diffuse bone marrow oedema [7,8,9]. All types of core decompression aim at pain reduction and long-term preservation of the femoral head provided that it has not yet collapsed [3, 17]. Differences in the rate of hip survival have been reported depending on the type of procedure performed, there are further factors that distinctly limit therapy success. Therapy is more likely to be jeopardised if known risk factors such as ongoing corticosteroid treatment or addictive alcohol consumption cannot be eliminated
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