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

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Yoon, Byung-Ho 
Jones, Lynne C 
Chen, Chung-Hwan 
Cheng, Edward Y 
Cui, Quanjun 

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.

Description

Keywords

Delphi, avascular necrosis, corticosteroid, femoral head, glucocorticoid, osteonecrosis, Advisory Committees, Consensus, Delphi Technique, Femur Head Necrosis, Glucocorticoids, Humans, Internationality, Prednisolone, Risk Factors

Journal Title

J Arthroplasty

Conference Name

Journal ISSN

0883-5403
1532-8406

Volume Title

34

Publisher

Elsevier BV