gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2017)

24.10. - 27.10.2017, Berlin

Joint preservation trends in the treatment of osteonecrosis of the femoral head

Meeting Abstract

  • presenting/speaker Michael Mont - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, United States
  • Jared M. Newman - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, United States
  • Anton Khlopas - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, United States
  • Morad Chughtai - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, United States
  • Anabelle Visperas - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, United States
  • Nicolas S. Piuzzi - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, United States
  • Lynne C. Jones - Director, Center for Osteonecrosis Research and Education, Johns Hopkins, Baltimore, United States
  • Steven F. Harwin - Mount Sinai Beth Israel, Center for Reconstructive Joint Surgery, New York, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocPO13-786

doi: 10.3205/17dkou641, urn:nbn:de:0183-17dkou6415

Published: October 23, 2017

© 2017 Mont et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Osteonecrosis of the femoral head is problematic because multiple treatment options such as hip joint preservation procedures have been suggested, yet the best treatment for various stages of the disease remains controversial. The purpose of this study was to characterize the trends for hip joint preservation surgical procedures performed for osteonecrosis of the femoral head in the United States between the years 2008 and 2014 to: 1) assess the frequency and rates of surgical procedures for the treatment of femoral head osteonecrosis; 2) determine the frequency and rate of joint preservation procedures; and 3) determine the frequency and rate of hemiarthroplasty/femoral head resurfacing of this cohort.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program, all patients who had a diagnosis of osteonecrosis of the femoral head and underwent hip joint preservation surgery or hemiarthroplasty/femoral head resurfacing between the years 2008 and 2014 were identified. The hip joint preservation surgical procedures included bone grafting, core decompression, osteotomy, and arthroscopy. The annual frequency and rate of the various surgical procedures were collected.

Results and Conclusion: From 2008 to 2014, the annual number of all surgical procedures for osteonecrosis of the femoral head increased from 88 to 1,161. While the number of core decompression procedures increased, the frequency of other joint preserving procedures stayed relatively the same. As a percentage of all surgical procedures, the percentage of all hip joint preservation procedures decreased from 17% to 3.3% (p<0.001). This corresponded to decreases in the percentage of bone grafting from 2.2% to 0.4%, core decompression from 12.5% to 2.8%, hip arthroscopy from 1.1% to 0.1%, and osteotomy from 1.1% to 0%. Over the same time period, the percentage of hemiarthroplasty/femoral head resurfacing decreased from 2.3% to 1.3%.

The frequency and rate of surgical procedures for osteonecrosis of the femoral head have increased over the years. However, the percentage of hip joint preservation procedures and hemiarthroplasty/femoral head resurfacing has decreased and makes up a smaller percentage of the total surgeries performed for treating osteonecrosis of the femoral head.