Purpose

Once collapsed, osteonecrosis of the femoral head (ONFH) generally obtains collapse cessation naturally and surgical intervention can be avoided in the long term. This study aimed to investigate the process of hip function and secondary osteoarthritis changes in ONFH patients undergoing conservative treatment.

Methods

We included 54 patients with symptomatic ONFH at the first visit with a minimum follow-up of three years with conservative treatment. Patients were divided into two groups based on collapse cessation < 3 mm (stable group) or progression to > 3 mm (progression group). Additionally, we investigated age, sex, body mass index (BMI), etiology, contralateral side hip joint, the Japanese Investigation Committee (JIC) type classification, Harris hip score (HHS), Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and survival rate with secondary osteoarthritis as the endpoint.

Results

The stable and progression groups had 31 and 23 patients, respectively. No significant differences in age, sex, BMI, and aetiology were observed between the two groups, except for the contralateral side hip joint and JIC type classification. The HHS and JHEQ were significantly improved at the final follow-up than at the first visit in the stable group. However, there were no significant differences in HHS and JHEQ at the final follow-up than at the first visit in the progression group. The five year survival rates with secondary osteoarthritis as the endpoint were significantly higher in the stable group (100%) than in the progression group (32.5%).

Conclusion

Hip joint function improved by continuing conservative treatment in ONFH patients with collapse cessation < 3 mm.

中文翻译：

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股骨头坏死保守治疗患者的髋关节功能

目的

一旦塌陷，股骨头坏死（ONFH）通常会自然停止塌陷，从长远来看可以避免手术干预。本研究旨在探讨接受保守治疗的ONFH患者髋关节功能及继发性骨关节炎改变的过程。

方法

我们纳入了 54 名首次就诊时有症状的 ONFH 患者，并进行了至少三年的保守治疗随访。根据塌陷停止 < 3 毫米（稳定组）或进展至 > 3 毫米（进展组），将患者分为两组。此外，我们调查了年龄、性别、体重指数 (BMI)、病因、对侧髋关节、日本调查委员会 (JIC) 类型分类、Harris 髋关节评分 (HHS)、日本骨科协会髋关节疾病评估问卷 (JHEQ) ，以及以继发性骨关节炎为终点的生存率。

结果

稳定组和进展组分别有 31 名和 23 名患者。除对侧髋关节和 JIC 类型分类外，两组在年龄、性别、BMI 和病因方面无显着差异。稳定组的 HHS 和 JHEQ 在最后一次随访时比第一次就诊时有显着改善。然而，与进展组首次就诊时相比，末次随访时的 HHS 和 JHEQ 无显着差异。稳定组（100%）以继发性骨关节炎为终点的五年生存率明显高于进展组（32.5%）。

结论

塌陷停止 < 3 mm 的 ONFH 患者通过继续保守治疗改善了髋关节功能。