Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 1: Glucocorticoid-Associated Osteonecrosis
- 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
- Issue Date
- Jan-2019
- Publisher
- CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
- Keywords
- osteonecrosis; avascular necrosis; femoral head; glucocorticoid; corticosteroid; Delphi
- Citation
- JOURNAL OF ARTHROPLASTY, v.34, no.1, pp 163 - +
- Journal Title
- JOURNAL OF ARTHROPLASTY
- Volume
- 34
- Number
- 1
- Start Page
- 163
- End Page
- +
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/18357
- DOI
- 10.1016/j.arth.2018.09.005
- ISSN
- 0883-5403
1532-8406
- Abstract
- Background: 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. Methods: 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. Results: 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. Conclusion: Association Research Circulation Osseous established classification criteria to standardize clinical studies concerning GA-ONFH. (C) 2018 Elsevier Inc. All rights reserved.
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