gms | German Medical Science

Objectives: The management of osteonecrosis of the femoral head (ONFH) is variable and influenced by physician preference and experience; stage of the disease; and patient population. While treatment algorithms have been suggested [1], no consensus exists within the medical community regarding which joint preservation procedures should be used and when.The American Association of Hip and Knee Surgeons (AAHKS) sent a questionnaire to their membership in 2005 regarding their current practices regarding the treatment of ONFH [2]. Unlike AAHKS, osteonecrosis is a major focus of the members of ARCO. Presentations at the international ARCO meetings have indicated a considerable variability between the treatments utilized worldwide. The aim of this study is to survey clinicians worldwide as to their management of ONFH patients.

Methods: The AAHKS survey was modified: 1) to identify the osteonecrosis classification system that they use, 2) to include the use of cell-based therapy and 3) to be able to be distributed electronically. Questions are included regarding the clinical practice of each participating surgeon, number of ONFH patients seen each year, and their perspectives for several different case scenarios. Qualtrics software (Provo, Utah) was used as a platform for an online survey.ARCO members and past attendees at ARCO international meetings will be provided with a link to the survey and a hard-copy. They will be instructed to distribute the survey to their network of colleagues who treat ONFH. Our goal is to recruit a minimum of 100 participants with a minimum of 10 participants from North America (US, Canada), Asia (Japan, Korea, Mainland China, Taiwan, India) and Europe (Germany, UK, Netherlands, etc.). Participation will be monitored and efforts will be made to acquire the desired number of participants. Data will be collected using the Qualtrics software and analyzed using JMP (SAS, Cary, NC). Incidental participant identifiers will be removed. Chi-Square analysis will be used to evaluate differences in frequencies between groups (e.g., countries, continents). Nonparametric and parametric analyses will be performed as appropriate.

Results and Conclusion: The results of this survey will be presented at the ARCO meeting to be held at the German Congress of Orthopedic and Trauma Surgery (DKOU) in Berlin in October, 2017.

There is limited evidence and randomized control trials regarding the effectiveness of treatments for joint preserving treatments for ONFH. This study is the first step towards conducting a collaborative research project internationally regarding the treatment of ONFH.