Long-term outcomes of conventional core decompression for osteonecrosis of the femoral head in systemic lupus erythematosus: a single-center retrospective study

OBJECTIVE: Although the thera-peutic efficacy of conventional core decompres-sion (CD) for the early-stage osteonecrosis (ON) has been widely investigated in the literature, no study to date has specifically focused on its therapeutic effect on the long-term outcome of ON of the femoral head (ONFH) in systemic lu-pus erythematosus (SLE). This study aimed to provide a long-term survival analysis of all hips that underwent conventional CD for the manage-ment of ONFH in a consecutive case series of patients with SLE.PATIENTS AND METHODS: Sixteen hips of 10 consecutive SLE patients that underwent conventional CD for the management of ONFH in a single tertiary referral center were retrospec-tively identified and included in the study. After a retrospective chart review, several clinical and radiological data were recorded. RESULTS: All the hips treated with CD were stage I or IIA sclerotic and/or cystic based on the classification system of Ficat. Only the 2 hips of 1 patient (12.5%) survived both clinically and radiographically. The median overall surviv-al for all hips after CD was 80 months (95% CI, 60-100). The 5-, 10-, and 15-year survival rates of hip joints following CD were 63%, 31%, and 12.5%, respectively (CI 95% 63.567 to 133.058 months).CONCLUSIONS: Conventional CD may not be effective in preventing the progression of pre-collapse ONFH to collapse and eventually end-stage osteoarthritis requiring arthroplasty in patients with SLE.

Automated summary

This study aimed to provide a long-term survival analysis of ONFH in patients with SLE who underwent conventional core decompression (CD) treatment. The results showed that CD may not be effective in preventing the progression of pre-collapse ONFH to end-stage osteoarthritis requiring arthroplasty in patients with SLE.