Mid-term prognosis of non-traumatic osteonecrosis of the femoral head
Mid-term prognosis of non-traumatic osteonecrosis of the femoral head
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DOI：
10.1302/0301-620x.85b6.13794
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发表时间：
2003-08-01
影响因子：
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通讯作者：
Minami, A
中科院分区：
文献类型：
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作者：
Ito, H;Matsuno, T;Minami, A
我们对77例（90髋）早期非创伤性股骨头坏死患者进行了平均9年的前瞻性随访。在最终审查时，56例（62%）有症状。采用考克斯模型，以Harris评分< 70分或手术治疗为终点，将放射学分期、分期进展、病灶缩小程度和MRI坏死体积百分比确定为危险因素，1年累积生存率为60.0%，2年为43.3%。5年为38.9%，10年为37.2%。生存曲线表明，临床恶化可能发生在首次诊断后90个月，这表明无症状患者应仔细随访数年。放射学上的时间依赖性尺寸减小而没有进行性塌陷可能代表修复，即使塌陷是最小的。
W e followed, prospectively, 77 patients (90 hips) with early-stage, non-traumatic osteonecrosis of the femoral head for a mean period of nine years. At the time of final review, 56 (62%) were symptomatic. Using the Cox model, the initial radiological stage, the progression of staging, the reduction in size of the lesions and the percentage of necrotic volume on MRI were identified as risk factors.Using the Harris score of < 70 or surgery as the endpoint, the cumulative rates of survival were 60.0% at one year, 43.3 % at two years, 38.9 % at five years and 37.2% at ten years. Survival curves demonstrated that clinical deterioration could occur 90 months after the initial diagnosis, suggesting that asymptomatic patients should be followed carefully for several years. Radiological time-dependent reduction in size without progressive collapse may represent repair even when the collapse is minimal.