Miyanishi Keita, Ishihara Kohei, Jingushi Seiya, Torisu Takehiko
Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Japan.
J Orthop Surg (Hong Kong). 2010 Dec;18(3):271-5. doi: 10.1177/230949901001800302.
To retrospectively evaluate factors leading to total hip arthroplasty (THA) in patients with subchondral insufficiency fractures (SIF) of the femoral head. METHODS. 5 men and 22 women aged 51 to 85 (mean, 72) years with SIF of the femoral head initially underwent conservative treatment. THA was later performed for 13 patients, as the hip pain became worse secondary to joint space narrowing and/ or femoral head collapse. Patient demographics and radiological variables were retrieved. Risk factors leading to THA in patients with SIF of the femoral head were identified. Receiver operating characteristic curves were used to determine optimal cut-off values for the significant risk factors.
2 men and 11 women aged 62 to 85 (mean, 74.9) years underwent THA and were followed up for 0.2 to 62 (mean, 13) months. The remaining 3 men and 11 women aged 51 to 81 (mean, 68) years underwent conservative treatment and were followed up for 9 to 93 (mean, 28) months. Patient age was the only risk factor for THA (p = 0.047, odds ratio = 1.13), the cutoff value being 71 years (sensitivity, 77%; specificity, 64%). The survival rate was significantly lower in patients aged 71 years or older than in those aged younger than 71 years (p < 0.05).
Elderly patients with SIF of the femoral head are at higher risk of undergoing THA.
回顾性评估导致股骨头软骨下骨不全骨折（SIF）患者行全髋关节置换术（THA）的因素。方法：5例男性和22例女性，年龄51至85岁（平均72岁），患有股骨头SIF，最初接受保守治疗。后来13例患者因关节间隙变窄和/或股骨头塌陷导致髋关节疼痛加重而接受了THA。收集患者的人口统计学和放射学变量。确定导致股骨头SIF患者行THA的危险因素。采用受试者工作特征曲线确定显著危险因素的最佳截断值。
2例男性和11例女性，年龄62至85岁（平均74.9岁），接受了THA，并随访0.2至62个月（平均13个月）。其余3例男性和11例女性，年龄51至81岁（平均68岁），接受了保守治疗，并随访9至93个月（平均28个月）。患者年龄是THA的唯一危险因素（p = 0.047，比值比 = 1.13），截断值为71岁（敏感性为77%；特异性为64%）。71岁及以上患者的生存率显著低于71岁以下患者（p < 0.05）。
老年股骨头SIF患者接受THA的风险较高。
