The 2021 Association Research Circulation Osseous Classification for Early-Stage Osteonecrosis of the Femoral Head to Computed Tomography-Based Study

被引：14

作者：

Koo, Kyung-Hoi ^{[1
,2
]}

Mont, Michael A. ^{[3
]}

Cui, Quanjun ^{[4
]}

Hines, Jeremy T. ^{[4
]}

Yoon, Byung-Ho ^{[5
]}

Novicoff, Wendy M. ^{[4
]}

Lee, Yun Jong ^{[6
,7
]}

Cheng, Edward Y. ^{[8
]}

Drescher, Wolf ^{[9
]}

Hernigou, Philippe ^{[10
]}

Kim, Shin-Yoon ^{[11
]}

Sugano, Nobuhiko ^{[12
]}

Zhao, De-Wei ^{[13
]}

Ha, Yong-Chan ^{[14
]}

Goodman, Stuart B. ^{[15
]}

Sakai, Takashi ^{[16
]}

Jones, Lynne C. ^{[17
]}

Lee, Mel S. ^{[18
]}

Yamamoto, Takuaki

Lee, Young-Kyun ^{[1
,2
]}

Kang, Yusuhn ^{[19
,20
]}

Burgess, James ^{[4
]}

Chen, Dennis ^{[4
]}

Quinlan, Nicole ^{[4
]}

Xu, Jian Zhong ^{[21
]}

Park, Jung-Wee ^{[1
,2
]}

Kim, Hong-Seok ^{[1
,2
]}

机构：

[1] Seoul Natl Univ, Dept Orthopaed Surg, Bundang Hosp, Seoul, South Korea

[2] Seoul Natl Univ, Coll Med, Seoul, South Korea

[3] Lenox Hill Hosp, Dept Orthopaed Surg, Northwell Hlth, New York, NY USA

[4] Univ Virginia, Dept Orthopaed Surg, Sch Med, Charlottesville, VA 22904 USA

[5] Ewha Womans Univ, Dept Orthopaed Surg, Coll Med, Seoul, South Korea

[6] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seoul, South Korea

[7] Seoul Natl Univ, Coll Med, Seoul, South Korea

[8] Univ Minnesota, Dept Orthopaed Surg, Med Sch, Minneapolis, MN USA

[9] Rhein Westfal TH Aachen, Dept Orthopaed & Trauma Surg, Aachen, Germany

[10] Hop Henri Mondor, Creteil, France

[11] Kyungpook Natl Univ, Grad Sch Med, Dept Orthopaed Surg, Daegu, South Korea

[12] Osaka Univ, Dept Orthopaed Med Engn, Grad Sch Med, Suita, Osaka, Japan

[13] Dalian Univ, Dept Orthopaed, Affiliated Zhongshan Hosp, Dalian, Peoples R China

[14] Chung Ang Univ, Dept Orthopaed Surg, Coll Med, Seoul, South Korea

[15] Stanford Univ, Dept Orthopaed Surg, Sch Med, Redwood City, CA USA

[16] Johns Hopkins Univ, Dept Orthopaed Surg, Sch Med, Baltimore, MD USA

[17] Kaohsiung Chang Gung Mem Hosp, Dept Orthopaed Surg, Kaohsiung, Taiwan

[18] Fukuoka Univ, Dept Orthopaed Surg, Fac Med, Fukuoka, Japan

[19] Seoul Natl Univ, Dept Diagnost Radiol, Bundang Hosp, Seoul, South Korea

[20] Seoul Natl Univ, Coll Med, Seoul, South Korea

[21] Zhengzhou Univ, Affiliated Hosp 1, Dept Orthopaed Surg, Zhengzhou, Peoples R China

来源：

JOURNAL OF ARTHROPLASTY | 2022年 / 37卷 / 06期

关键词：

South Korea; Korea; femoral head; avascular necrosis; AVASCULAR NECROSIS; NONTRAUMATIC OSTEONECROSIS; SYSTEM; CT;

D O I：

10.1016/j.arth.2022.02.009

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: The Association Research Circulation Osseous developed a novel classification for early stage (precollapse) osteonecrosis of the femoral head (ONFH). We hypothesized that the novel classification is more reliable and valid when compared to previous 3 classifications: Steinberg, modified Kerboul, and Japanese Investigation Committee classifications. Methods: In the novel classification, necrotic lesions were classified into 3 types: type 1 is a small lesion, where the lateral necrotic margin is medial to the femoral head apex; type 2 is a medium-sized lesion, with the lateral necrotic margin being between the femoral head apex and the lateral acetabular edge; and type 3 is a large lesion, which extends outside the lateral acetabular edge. In a derivation cohort of 40 early-stage osteonecrotic hips based on computed tomography imaging, reliabilities were evaluated using kappa coefficients, and validities to predict future femoral head collapse by chi-squared tests and receiver operating characteristic curve analyses. The predictability for future collapse was also evaluated in a validation cohort of 104 early-stage ONFH. Results: In the derivation cohort, interobserver reliability (k = 0.545) and intraobserver agreement (63%10 0%) of the novel method were higher than the other 3 classifications. The novel classification system was best able to predict future collapse (P < .05) and had the best discrimination between nonprogressors and progressors in both the derivation cohort (area under the curve = 0.692 [0.5220.863], P < .05) and the validation cohort (area under the curve = 0.742 [0.644-0.841], P = 2.46 x 10-5). Conclusion: This novel classification is a highly reliable and valid method of those examined. Association Research Circulation Osseous recommends using this method as a unified classification for early-stage ONFH. Level of Evidence: Level III, diagnostic study. (c) 2022 Elsevier Inc. All rights reserved.

引用

页码：1074 / 1082

页数：9

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