Outcomes of the conservative hip preservation treatment in patients with osteonecrosis of the femoral head: With 4-year follow-up
Bibliographic record
Abstract
BACKGROUND Osteonecrosis of the femoral head (ONFH) is a prevalent clinical condition, and as the affected population becomes younger and more widespread, an increasing number of patients prefer to retain their own hip joints. In comparison to joint replacement and hip-preserving surgeries, conservative hip preservation treatment is gaining more recognition from both clinicians and patients. AIM To observe the clinical efficacy and influencing factors of conservative hip preservation treatment for patients with ONFH. METHODS A total of 73 patients (119 hips) were included, and patients were grouped based on Association Research Circulation Osseous (ARCO) stage, Japanese Investigation Committee (JIC) classification, lesion size, and collapse degree. The clinical efficacy of conservative hip preservation treatment was evaluated from two aspects: Radiological progression and clinical functional scores [Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index (WOMAC), international Hip Outcome Tool 12 (iHOT-12), and visual analogue scale (VAS)]. Analyzing the success rate of conservative hip preservation based on conversion to total hip arthroplasty or hip preservation surgery. RESULTS In this retrospective cohort study, we retrospectively analyzed 73 patients (119 hips) with an average follow-up time of 53.58 ± 26.80 (18-129) months. The overall success rate of hip preservation is 90.76%. The success rates of hip preservation in ARCO I-II, IIIa, and IIIb were 97.67%, 91.53%, and 70.59%, respectively (P < 0.05). The success rates of hip preservation for JIC A-B, C1, and C2 were 93.37%, 92.59%, and 77.78%, respectively (P < 0.05). The success rates of hip preservation with collapse degree ≤ 2 mm and > 2 mm were 94.12% and 70.59%, respectively (P < 0.05). There was no significant difference in the success rate of hip preservation between different lesion sizes. In terms of clinical function, the Harris Hip Score, WOMAC, iHOT-12, and VAS scores at the last follow-up were significantly better than before treatment (P < 0.05). The VAS scores of ARCO IIIa and IIIb were significantly worse than those of ARCO I and II (P < 0.05). The iHOT-12, WOMAC, and VAS scores were significantly better with the lesion size < 15% (P < 0.05). In terms of radiological results, there was significant progress in ARCO staging and collapse degree after conservative hip preservation treatment, but there was no significant difference in JIC classification and lesion size. CONCLUSION Conservative hip preservation treatment can effectively treat ONFH, prevent the progression of the necrosis, and significantly improve the clinical function of patients. The radiological staging and lesion size at the initial visit may help determine the prognosis of conservative hip preservation treatment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".