{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:42:00Z","timestamp":1788547320873,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate whether core decompression could prevent progression of asymptomatic type C osteonecrosis of the femoral head (ONFH) according to the Japanese Investigation Committee (JIC) classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study included 124 hips (117 patients) with asymptomatic type C ONFH. Seventy\u2010one hips (67 patients) received core decompression (core decompression group) and 53 hips (50 patients) received no surgical treatment (control group). Clinical and radiological follow\u2010up was conducted at 6 and 12\u00a0months, then annually until 5\u2009years. Clinical outcomes were evaluated in terms of the Oxford hip score and UCLA Activity Level rating. Radiological outcomes were evaluated using X\u2010ray and magnetic resonance imaging. Survival analysis was performed based on collapse of the femoral head as the first endpoint and total hip arthroplasty (THA) as the second endpoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in clinical outcomes between the core decompression group and the control group within 2\u2009years after surgery. Patients in the core decompression group had significantly better Oxford hip score and UCLA Activity Level from year 3 to the end of follow\u2010up (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). In year 5, the absolute difference in Oxford hip score (5.3 points) exceeded the reported minimal clinically important difference (MCID, 5.2 points). In years 3\u20135, the absolute difference in UCLA Activity Level rating (0.95 points, 0.95 points, and 0.99 points, respectively) exceeded the reported MCID (0.92 points). By 5\u2010year follow\u2010up, significantly fewer patients in the core decompression group had experienced femoral head collapse (40.8% <jats:italic>vs<\/jats:italic> 62.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.011) or received THA (26.8% <jats:italic>vs<\/jats:italic> 45.3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Core decompression can prevent progression of asymptomatic type C ONFH according to the JIC classification, leading to better medium\u2010term hip function and activity levels than no surgical treatment. Core decompression is recommended for early intervention against asymptomatic type C ONFH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13213","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T08:14:57Z","timestamp":1650269697000},"page":"851-859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Core Decompression Prevents Progression of Asymptomatic Type C Osteonecrosis of Femoral Head According to the Japanese Investigation Committee Classification: A Retrospective Study"],"prefix":"10.1111","volume":"14","author":[{"given":"Qiu\u2010ru","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Surgery West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010jing","family":"An","sequence":"additional","affiliation":[{"name":"Public Laboratory Technology Center West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u2010li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Public Laboratory Technology Center West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou\u2010yuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Surgery West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Surgery West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-0796","authenticated-orcid":false,"given":"Peng\u2010de","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Surgery West China 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