{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T23:00:45Z","timestamp":1766530845105,"version":"3.37.3"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:00:00Z","timestamp":1631232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Osteonecrosis of the femoral head (ONFH) is a designated intractable disease (DID) in Japan. The Ministry of Health, Labour, and Welfare launched an online registry system for DIDs. We aimed to investigate the epidemiological characteristics of patients with ONFH using the DID database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of patients with ONFH registered in the DID database between January 2004 and December 2013 were extracted. The incidence of new cases and distributions of sex, age, and associated risk factors were investigated. The prevalence of the two categories, \u2018steroid-associated\u2019 and \u2018alcohol-associated\u2019 risk factors, was estimated for each prefecture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>New 15,049 cases of ONFH were investigated. The mean registration rate-corrected annual ONFH incidence per 100,000 individuals was 1.77. The male-to-female ratio was 1.33. Age distribution peaked in the 40s and 50s for male and 60s for female. The prevalence of steroid-associated ONFH was lower in males (28.6%) than in females (49.8%), while that of alcohol-associated ONFH was higher in males (47.2%) than in females (9.3%). No clear region was identified for the steroids. The incidence of alcohol-associated ONFH was significantly higher in Tokyo and Okinawa, regardless of sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Alcohol-associated ONFH incidence varies geographically across Japan, suggesting that it has regional characteristics.<\/jats:p><\/jats:sec>","DOI":"10.1093\/mr\/roab065","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:18:57Z","timestamp":1633915137000},"page":"1006-1012","source":"Crossref","is-referenced-by-count":4,"title":["Geographical distribution of the associated factors of osteonecrosis of the femoral head, using the designated intractable disease database in Japan"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9352-465X","authenticated-orcid":false,"given":"Wataru","family":"Ando","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine , Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Takao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine , Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine , Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine , Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetoshi","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine , Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiko","family":"Sugano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine , Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,10]]},"reference":[{"key":"2022082013391021100_R1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jos.2020.06.013","article-title":"Japanese Orthopaedic Association 2019 Guidelines for osteonecrosis of the femoral head","volume":"26","author":"Ando","year":"2021","journal-title":"J Orthop Sci"},{"key":"2022082013391021100_R2","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1016\/j.arth.2009.05.022","article-title":"Prevalence of osteonecrosis of the femoral head: a nationwide epidemiologic analysis in Korea","volume":"24","author":"Kang","year":"2009","journal-title":"J Arthroplasty"},{"key":"2022082013391021100_R3","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/os.12857","article-title":"Epidemiological study based on China osteonecrosis of the femoral head database","volume":"13","author":"Tan","year":"2021","journal-title":"Orthop Surg"},{"key":"2022082013391021100_R4","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1007\/s11999-010-1292-x","article-title":"Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head","volume":"468","author":"Fukushima","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"2022082013391021100_R5","first-page":"1","article-title":"Geographic distribution of the incidence of osteonecrosis of the femoral head in Japan and its relation to smoking prevalence","volume":"10","author":"Tani","year":"2021","journal-title":"Mod Rheumatol"},{"key":"2022082013391021100_R6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2176\/nmc.st.2016-0135","article-title":"National registry of designated intractable diseases in Japan: present status and future prospects","volume":"57","author":"Kanatani","year":"2017","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"2022082013391021100_R7","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1302\/0301-620X.81B4.0810590","article-title":"Diagnostic criteria for non-traumatic osteonecrosis of the femoral head: a multicentre study","volume":"81","author":"Sugano","year":"1999","journal-title":"J Bone Joint Surg [Br]"},{"key":"2022082013391021100_R8","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s007760200108","article-title":"The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head","volume":"7","author":"Sugano","year":"2002","journal-title":"J Orthop Sci"},{"volume-title":"TablE 1. 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