Abstract
BackgroundNontraumatic osteonecrosis of the femoral head (ONFH) is a rare disorder caused by ischemic necrosis of unknown etiology. A few studies have demonstrated trends in the number of patients with ONFH. However, there are no data on temporal trends in characteristics such as age, gender, and causative factors. To investigate this, we examined data from a multicenter hospital-based sentinel monitoring system in Japan.MethodsA total of 3041 newly-diagnosed ONFH patients from 34 participating hospitals who were reported to the system from 1997–2011 were analyzed. We examined age at diagnosis, potential causative factors, and underlying diseases for which patients received systemic steroid administration. Their temporal trends were assessed according to date of diagnosis in 5-year intervals (1997–2001, 2002–2006, and 2007–2011).ResultsThe gender ratio and distribution of potential causative factors did not change. Regarding underlying diseases requiring steroid administration, the proportion of patients with systemic lupus erythematosus decreased in males (10% to 6.4%) and in females (37% to 29%). Proportion of patients with renal transplantation fell consistently across the study period in both males (3.8% to 1.2%) and females (3.2% to 0.8%). In contrast, the proportion of patients receiving steroids for pulmonary disease (except asthma) significantly increased in both males (0.5% to 5.5%) and females (0.5% to 3.6%).ConclusionsThis large descriptive study is the first to investigate temporal trends in the characteristics of ONFH, which provide useful information for future studies.
Highlights
Nontraumatic osteonecrosis of the femoral head (ONFH) is a disorder of unknown pathogenesis that often progresses to hip joint destruction and physical disability.[1]
In the present study, using data collected in a multicenter hospital-based sentinel monitoring system in Japan over a period of 15 years, we evaluated temporal trends in ONFH with respect to basic characteristics, including gender ratio, age at diagnosis, potential causative factors, and underlying diseases treated by systemic steroid administration
When a patient was newly diagnosed with ONFH at one of the participating hospitals, the demographic and clinical information of the patient was reported to the monitoring system
Summary
Nontraumatic osteonecrosis of the femoral head (ONFH) is a disorder of unknown pathogenesis that often progresses to hip joint destruction and physical disability.[1]. ONFH is a rare disease, and its annual incidence in Japan has been reported to be an average of 2.51 cases per 100 000 persons between 1999 and 2008.2 Some epidemiologic studies have shown an increase in the number of patients with ONFH in recent years.[3,4,5] Kang et al[3] conducted a nationwide survey between 2002 and 2006 using medical claims data from the National Health Insurance Corporation to estimate the prevalence in Korea. We examined age at diagnosis, potential causative factors, and underlying diseases for which patients received systemic steroid administration Their temporal trends were assessed according to date of diagnosis in 5-year intervals (1997–2001, 2002–2006, and 2007–2011). Conclusions: This large descriptive study is the first to investigate temporal trends in the characteristics of ONFH, which provide useful information for future studies
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