Vardhan Harsha, Tripathy Sujit Kumar, Sen Ramesh Kumar, Aggarwal Sameer, Goyal Tarun
Department of Orthopedics, PGIMER, Chandigarh, India.
Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian J Orthop. 2018 Mar-Apr;52(2):140-146. doi: 10.4103/ortho.IJOrtho_292_16.
There are limited studies on the epidemiology of femoral head osteonecrosis in Indian population. This study was designed to look for the risk factors of osteonecrosis hip and to assess the severity as per radiological staging (Association Research Circulation Osseous [ARCO]) and clinical score (Harris hip score [HHS]).
249 patients (382 hips) of osteonecrosis femoral head (ONFH) who were evaluated at our center between January 1, 2005, and June 30, 2013, were included in this retrospective study. The details of history, clinical examination, radiological grading, and HHS were entered into a proforma.
The mean age was 34.71 years (range 14-70 years) and 70.28% (=175) patients were between 20 and 40 years. Male to female ratio was 5:1. Bilateral ONFH was observed in 53.41% (=133) patients. In atraumatic conditions, bilateral involvement was seen in 61.61% (130/211) patients. Steroid administration (37.3%, 93/249) was most commonly observed in the patients followed by idiopathic in 21.3% (53/249) patients, chronic alcohol consumption in 20.1% (50/249) patients, and trauma in 15.3% (38/249) patients. There were 48% (185/382) hips in ARCO Stage 2 followed by 33% (125/382) in Stage 3 and 16% (61/382) in Stage 4. The mean HHS was 80.97 ± 14.35 in unilateral ONFH. The mean HHS was 72.79 ± 14.43 and 80.07 ± 13.52 in more involved hip and in less involved hip, respectively, in bilateral ONFH. The ARCO staging had statistically significant correlation with HHS (Pearson's correlation coefficient = -0.783, < 0.01) in unilateral ONFH patients and more severely affected hip in bilateral (Pearson's correlation coefficient = -0.654, < 0.01) ONFH, but it did not show any association with less involved hip in bilateral cases.
ONFH in the North Indian patients is a disease of young individuals with male predominance. Steroid intake is most commonly observed in these patients followed by idiopathic, chronic alcohol consumption, and trauma.
关于印度人群股骨头坏死流行病学的研究有限。本研究旨在寻找髋部坏死的危险因素，并根据放射学分期（骨循环研究协会[ARCO]）和临床评分（Harris髋关节评分[HHS]）评估严重程度。
本回顾性研究纳入了2005年1月1日至2013年6月30日期间在我们中心接受评估的249例股骨头坏死（ONFH）患者（382髋）。将病史、临床检查、放射学分级和HHS的详细信息录入表格。
平均年龄为34.71岁（范围14 - 70岁），70.28%（=175）的患者年龄在20至40岁之间。男女比例为5:1。53.41%（=133）的患者观察到双侧ONFH。在非创伤性情况下，61.61%（130/211）的患者出现双侧受累。患者中最常见的是使用类固醇（37.3%，93/249），其次是特发性（21.3%，53/249）、慢性酒精摄入（20.1%，50/249）和创伤（15.3%，38/249）。ARCO 2期有48%（185/382）的髋，3期有33%（125/382），4期有16%（61/382）。单侧ONFH的平均HHS为80.97±14.35。双侧ONFH中，受累较重髋的平均HHS为72.79±14.43，受累较轻髋的平均HHS为80.07±13.52。在单侧ONFH患者中，ARCO分期与HHS有统计学显著相关性（Pearson相关系数 = -0.783，<0.01），在双侧ONFH中与受累较重髋有相关性（Pearson相关系数 = -0.654，<0.01），但在双侧病例中与受累较轻髋无关联。
北印度患者的ONFH是一种以男性为主的年轻人疾病。这些患者中最常见的是摄入类固醇，其次是特发性、慢性酒精摄入和创伤。
