학술논문
Time elapsed from definitive diagnosis to surgery for osteonecrosis of the femoral head: a nationwide observational study in Japan
Document Type
article
Author
Hiroshi Ito; Makoto Osaki; Kenji Ohzono; Sakae Tanaka; Yohei Kawasaki; Wataru Ando; Masaki Takao; Yasuyuki Ishibashi; Nobuhiko Sugano; Daisuke Takahashi; Junichi Nakamura; Goro Motomura; Takuaki Yamamoto; Shinya Hayashi; Etsuo Chosa; Hiroaki Nakamura; Yuji Yamamoto; Yoshihide Nakamura; Michiaki Takagi; Akihiro Sudo; Satoshi Nagoya; Toshikazu Kubo; Yutaka Inaba; Yukiharu Hasegawa; Yasuharu Nakashima; Setsuro Komiya; Yuki Shiko; Yuya Kawarai; Shigeo Hagiwara; Satoshi Nakasone; Masaaki Mawatari; Wakaba Fukushima; Takashi Sakai; Kazuya Ito; Yoshiya Arishima; Yusuke Fujimoto; Kazuo Fujiwara; Takashi Imagama; Yasuhiro Ishidou; Hideya Ito; Juji Ito; Tetsuya Jinno; Tamon Kabata; Nobuhiro Kaku; Ayumi Kaneuji; Shunji Kishida; Seneki Kobayashi; Tokifumi Majima; Naohiko Mashima; Hidenobu Miki; Kazumasa Miyatake; Ryosuke Nakanishi; Takashi Nishii; Takayuki Nishiyama; Yoichi Ohta; Kan Sasaki; Taisuke Seki; Takaaki Shishido; Takeshi Shoji; Takeyuki Tanaka; Tomonori Tetsunaga; Keiichiro Ueshima; Kengo Yamamoto; Takuma Yamasaki; Yuji Yasunaga
Source
BMJ Open, Vol 14, Iss 3 (2024)
Subject
Language
English
ISSN
2044-6055
Abstract
Objectives This study documents the time elapsed from the diagnosis of osteonecrosis of the femoral head (ONFH) to surgery, exploring the factors that influence ONFH severity.Design Retrospective observational study of a nationwide database.Setting The Kaplan-Meier method with log-rank tests was applied to examine the period from definitive diagnosis of ONFH to surgery using any surgery as the end point. For bilateral cases, the date of the first surgery was the endpoint.Participants This study included 2074 ONFH cases registered in 34 university hospitals and highly specialised hospitals of the multicentre sentinel monitoring system of the Japanese Investigation Committee between 1997 and 2018.Main outcome measure The primary outcome was the time from diagnosis to surgery. The secondary outcome was the proportion of subjects remaining without surgery at 3, 6 and 9 months, and at 1, 2 and 5 years after diagnosis.Results The median time to surgery was 9 months (IQR 4–22 months) after diagnosis of ONFH. The time to surgery was significantly shorter in the alcohol alone group and the combined corticosteroid and alcohol group than in the corticosteroid alone group (p=0.018 and p