Mont Michael A, Marulanda German A, Jones Lynne C, Saleh Khaled J, Gordon Noah, Hungerford David S, Steinberg Marvin E
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.
J Bone Joint Surg Am. 2006 Nov;88 Suppl 3:16-26. doi: 10.2106/JBJS.F.00457.
Multiple classification systems for osteonecrosis of the hip have been developed to assist physicians in the diagnosis and treatment of this potentially debilitating disorder. The purpose of this analysis was to delineate the classification systems utilized in reports published since 1985 and, through a comparison of the most commonly used systems, to identify consistent factors that would allow for cross-publication comparisons to be made.
We performed a PubMed search for reports of outcome studies concerning treatment methods for osteonecrosis of the hip. All studies of reported outcomes with greater than ten patients were included in the analysis. Various classification systems were tabulated to determine usage frequencies. The four most commonly used systems were then analyzed to determine common factors used for classification.
One hundred and fifty-seven studies were available for analysis. Sixteen major classification systems that made use of more than one radiographic factor were identified, and nine of these systems had one to five modifications reported throughout the literature. Additionally, eleven other systems made use of single factors obtained from either magnetic resonance imaging or anatomic data. The review revealed that four classification systems accounted for greater than 85.4% of the reported studies. Parameters for these four systems were stratified to allow for uniformity of patient or study evaluation.
This analysis of the reported classification systems for osteonecrosis of the femoral head revealed several similarities between the most commonly used systems. An analysis of patients can be made with any of the four major systems if specific data are collected according to various magnetic resonance imaging and radiographic findings. This approach will allow for easier comparison of studies across different centers.
Prognostic Level III. See Instructions to Authors on jbjs.org for a complete description of levels of evidence.
已开发出多种用于诊断和治疗这种可能使人衰弱的髋关节坏死疾病的分类系统，以协助医生进行诊断和治疗。本分析的目的是描述自1985年以来发表的报告中所使用的分类系统，并通过比较最常用的系统，确定能够进行跨出版物比较的一致因素。
我们在PubMed上搜索了有关髋关节坏死治疗方法的结果研究报告。所有报告结果且患者人数超过十人的研究均纳入分析。将各种分类系统制成表格以确定使用频率。然后分析四个最常用的系统，以确定用于分类的共同因素。
共有157项研究可供分析。确定了16种使用多个影像学因素的主要分类系统，其中9种系统在文献中报告有1至5种修改。此外，还有11种其他系统使用了从磁共振成像或解剖学数据中获得的单一因素。该综述显示，四种分类系统占报告研究的85.4%以上。对这四种系统的参数进行了分层，以实现患者或研究评估的一致性。
对已报告的股骨头坏死分类系统的分析揭示了最常用系统之间的几个相似之处。如果根据各种磁共振成像和影像学结果收集特定数据，则可以使用四种主要系统中的任何一种对患者进行分析。这种方法将使不同中心的研究更容易进行比较。
预后III级。有关证据水平的完整描述，请参阅jbjs.org上的作者指南。
