Current Treatment Modalities for Osteonecrosis of Femoral Head in Mainland China: A Cross‐Sectional Study

Objective To investigate the application of treatment modalities for patients with osteonecrosis of the femoral head (ONFH) in mainland China. Methods This cross‐sectional study was based on the online application of China Osteonecrosis of the Femoral Head Database (CONFHD). Between July 2016 to Dec...

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Published inOrthopaedic surgery Vol. 12; no. 6; pp. 1776 - 1783
Main Authors Huang, Ze‐qing, Fu, Fan‐yu, Li, Wen‐long, Tan, Biao, He, Hai‐jun, Liu, Wen‐gang, Chen, Wei‐heng
Format Journal Article
LanguageEnglish
Published Melbourne John Wiley & Sons Australia, Ltd 01.12.2020
John Wiley & Sons, Inc
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Summary:Objective To investigate the application of treatment modalities for patients with osteonecrosis of the femoral head (ONFH) in mainland China. Methods This cross‐sectional study was based on the online application of China Osteonecrosis of the Femoral Head Database (CONFHD). Between July 2016 to December 2018, the CONFHD program planned to recruit ONFH patients from 12 administrative areas across mainland China. Real‐world medical records of treatment regimens for these patients, including surgeries and prescriptions, were approved to upload to the CONFHD application for further analysis. The surgeries performed on these patients were classified into total hip arthroplasty and hip‐preserving procedures, and the latter was further classified into core decompression, bone grafting, and tantalum rod implantation. Prescription medications were classified into chemical medicine and Chinese herbal medicine (CHM); chemical medicine was further classified according to their chemical compounds, and CHM was classified according to therapeutic functions based on traditional Chinese medicine theory. Descriptive analysis was performed to summarize the application of different treatment regimens on the overall sample. Results A total of 1491 patients (2381 hips) who fulfilled the protocol criteria were included. There were 1039 males and 452 females with a mean age of 47.29 ± 12.69 years. The causes of ONFH were alcoholism in 642 patients (43%), corticosteroid in 439 patients (29%), trauma in 239 patients (16%), and idiopathic ONFH in 171 patients (11%). Operative treatments (including total hip arthroplasty and hip‐preserving procedures) were performed on 49% of patients (43% of hips), chemical medicine therapy (including bisphosphonate, statins, and prostacyclin) was given to 37% of patients (37% of hips), and CHM was administrated to 72% of patients (75% of hips). The aforementioned interventions were not always used alone, since 47% of patients (52% of hips) received combined regimens with multiple interventions. Among hips treated by surgery, all hips with ARCO stage IV ONFH received THA (305 hips), and THA was also performed on 63 hips with stage II ONFH. Over half of hips with stage I (81%), II (91%), and III (92%) ONFH had received pharmacological treatments. Prostacyclin and bisphosphonate were the top two most prescribed medicines used alone. CHM therapies with multiple CHM functions were more commonly prescribed. Conclusion Current treatment modalities for ONFH patients in mainland China include operative treatment, chemical medicine, and CHM. Combined regimens with different treatment modalities are common in real‐world clinical practices. A cross‐sectional study to investigate the application of treatment modalities for patients with osteonecrosis of the femoral head in mainland China based on the China Osteoncrosis of the Femoral Head Database's (CONFHD) online platform.
Bibliography:These authors contributed equally to this work.
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Disclosure
This study was supported by grants from the National Natural Science Foundation of China (No. 81873322 and No. 81973888) and Beijing Municipal Natural Science Foundation of China (No. 7182186).
The authors declare that they have no conflict of interest. This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent was obtained from the individual participants included in the study. Derived data supporting the findings of this study are available from the corresponding authors on request.
Disclosure: The authors declare that they have no conflict of interest. This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent was obtained from the individual participants included in the study. Derived data supporting the findings of this study are available from the corresponding authors on request.
Grant Sources: This study was supported by grants from the National Natural Science Foundation of China (No. 81873322 and No. 81973888) and Beijing Municipal Natural Science Foundation of China (No. 7182186).
ISSN:1757-7853
1757-7861
DOI:10.1111/os.12810