Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 1: Glucocorticoid-Associated Osteonecrosis

Glucocorticoid usage, a leading cause of osteonecrosis of the femoral head (ONFH), and its prevalence was reported in 25%-50% of non-traumatic ONFH patients. Nevertheless, there have been no unified criteria to classify glucocorticoid-associated ONFH (GA-ONFH). In 2015, the Association Research Circ...

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Published in:The Journal of arthroplasty 2019-01, Vol.34 (1), p.163-168.e1
Main Authors: Yoon, Byung-Ho, Jones, Lynne C., Chen, Chung-Hwan, Cheng, Edward Y., Cui, Quanjun, Drescher, Wolf, Fukushima, Wakaba, Gangji, Valerie, Goodman, Stuart B., Ha, Yong-Chan, Hernigou, Philippe, Hungerford, Marc, Iorio, Richard, Jo, Woo-Lam, Khanduja, Vikas, Kim, Harry, Kim, Shin-Yoon, Kim, Tae-Young, Lee, Hee Young, Lee, Mel S., Lee, Young-Kyun, Lee, Yun Jong, Mont, Michael A., Sakai, Takashi, Sugano, Nobuhiko, Takao, Masaki, Yamamoto, Takuaki, Koo, Kyung-Hoi
Format: Article
Language:English
Subjects:
avascular necrosis
corticosteroid
Delphi
femoral head
glucocorticoid
osteonecrosis
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Summary:Glucocorticoid usage, a leading cause of osteonecrosis of the femoral head (ONFH), and its prevalence was reported in 25%-50% of non-traumatic ONFH patients. Nevertheless, there have been no unified criteria to classify glucocorticoid-associated ONFH (GA-ONFH). In 2015, the Association Research Circulation Osseous addressed the issue of developing a classification scheme. In June 2017, a task force was set up to conduct a Delphi survey concerning ONFH. The task force invited 28 experts in osteonecrosis/bone circulation from 8 countries. Each round of the Delphi survey consists of questionnaires, analysis of replies, and feedback reports to the panel. After 3 rounds of the survey, the panel reached a consensus on the classification criteria. The response rates were 100% (Round 1), 96% (Round 2), and 100% (Round 3), respectively. The consensus on the classification criteria of GA-ONFH included the following: (1) patients should have a history of glucocorticoid use >2 g of prednisolone or its equivalent within a 3-month period; (2) osteonecrosis should be diagnosed within 2 years after glucocorticoid usage, and (3) patients should not have other risk factor(s) besides glucocorticoids. Association Research Circulation Osseous established classification criteria to standardize clinical studies concerning GA-ONFH.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2018.09.005