{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:13:57Z","timestamp":1779934437767,"version":"3.53.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"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":[[2023,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>At present, there is no consensus or guidance on indications for osteonecrosis of the femoral head (ONFH) patients to receive hip arthroplasty (THA) treatment. This study aims to explore the factors that influence the decision\u2010making for THA in patients with ONFH, and to provide references for clinical decision for ONFH patients to be indicated for THA or hip preservation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective case\u2013control study involved data for ONFH patients from July 2016 to October 2021 from the China Osteonecrosis of the Femoral Head Database (CONFHD). The patients with ONFH, and unilateral hip affected at the first visit were divided into THA group and non\u2010THA group according to if they had undergone THA treatment. The differences between the two groups of patients in terms of gender, age at the time of consultation, body mass index (BMI), etiology, onset side, association research circulation osseous (ARCO) stage, hip joint function, visual analog scale (VAS), etc. were analyzed. Multivariate binomial logistic regression analysis was then applied to evaluate the risk factors of ONFH patients who underwent THA during the first visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 640 patients were recruited for analysis, including 209 cases from the THA group and 431 cases from the non\u2010THA group. The results of univariate analysis showed that the two groups of patients were significantly different in the following six indicators: age (59 vs. 46, Z\u00a0=\u00a0\u22129.58, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), duration of disease (78 vs. 17, Z\u00a0=\u00a0\u201316.14, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), gender composition (\u03c7<jats:sup>2<\/jats:sup>\u00a0=\u00a08.09, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004), disease etiology (\u03c7<jats:sup>2<\/jats:sup>\u00a0=\u00a033.04, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), ARCO stage (\u03c7<jats:sup>2<\/jats:sup>\u00a0=\u00a0334.86, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), flexion of hip joint (\u03c7<jats:sup>2<\/jats:sup>\u00a0=\u00a0172.33, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). However, the comparison between the two groups on VAS (Z\u00a0=\u00a0\u20130.82, <jats:italic>p\u2009=<\/jats:italic>\u00a00.41), BMI (Z\u00a0=\u00a0\u20131.35, <jats:italic>p\u2009=<\/jats:italic>\u00a00.18), and onset side (\u03c7<jats:sup>2<\/jats:sup>\u00a0=\u00a01.53, <jats:italic>p\u2009=<\/jats:italic>\u00a00.22) did not obviously differ. The results regression analysis showed that the age at the time of consultation, duration of disease, ARCO stage, and the hip joint function affected the decision making if the patients should undergo THA. The results of receiver operating characteristic curve (ROC) analysis showed that aforementioned indicators were satisfactory in predicting whether patients with ONFH would be treated with THA. The regression model using the above four indicators as comprehensive indicators has satisfactory performance in predicting whether to perform THA, and the area under the curve (AUC) is 93.94%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These factors such as age, duration of disease, ARCO stage, and hip flexion function should be considered comprehensively before making decisions to perform THA or not in our clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13639","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T16:20:12Z","timestamp":1673367612000},"page":"731-739","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hip Preservation or Total Hip Arthroplasty? A Retrospective Case\u2013Control Study of Factors Influencing Arthroplasty Decision\u2010Making for Patients with Osteonecrosis of the Femoral Head in China"],"prefix":"10.1111","volume":"15","author":[{"given":"Wei","family":"Wei","sequence":"first","affiliation":[{"name":"The Third Affiliated Hospital of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7262-9850","authenticated-orcid":false,"given":"Biao","family":"Tan","sequence":"additional","affiliation":[{"name":"Chongqing Traditional Chinese Medicine Hospital  Chongqing China"},{"name":"Wangjing Hospital China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-3390","authenticated-orcid":false,"given":"Wenlong","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Hepingli Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangrong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Guizhou University of Traditional Chinese Medicine  Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianglong","family":"Chen","sequence":"additional","affiliation":[{"name":"Guizhou University of Traditional Chinese Medicine  Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongtian","family":"Wang","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijun","family":"He","sequence":"additional","affiliation":[{"name":"Wangjing Hospital China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics &amp; Traumatology, Musculoskeletal Research Laboratory Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health, The Chinese University of Hong Kong, Hong Kong Special Administrative Region  China"},{"name":"Translational Medicine R&amp;D Center Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taixian","family":"Li","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiheng","family":"Chen","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197207000-00008"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-10817-w"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.4.180036"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2021.01.002"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01271"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.102B7.BJJ-2019-1611.R1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.01.008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.08.005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-017-1662-6"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-3981-0"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3344-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2010.12.010"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200301000-00004"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2019.12.005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00011"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-015-3061-7"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-3220-3"},{"issue":"1","key":"e_1_2_8_19_1","first-page":"1","article-title":"Current status and challenges of China osteonecrosis of the femoral head database","volume":"32","author":"Chen WH","year":"2020","journal-title":"J Trad Chin Orthop Trauma"},{"issue":"1","key":"e_1_2_8_20_1","first-page":"51","article-title":"Analysis of population characteristics and clinical characteristics of patients with femoral head necrosis and total hip arthroplasty","volume":"32","author":"Xu K","year":"2020","journal-title":"J Trad Chin Orthop Trauma"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12857"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12821"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12810"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.11.029"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002148"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-019-1364-x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453670903039544"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B10.17399"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2017.32.4.581"},{"issue":"17","key":"e_1_2_8_30_1","first-page":"1431","article-title":"The risk factors analysis for 3364 patients who underwent total hip replacements","volume":"19","author":"Tan G","year":"2011","journal-title":"Orthop J of Chin"},{"issue":"6","key":"e_1_2_8_31_1","first-page":"733","article-title":"A retrospective analysis of 1459 cases of primary hip replacements for osteopathic patients during past 30\u2009years","volume":"5","author":"Xu DL","year":"2011","journal-title":"Chin J Joint Surg (Electronic Edition)"},{"key":"e_1_2_8_32_1","first-page":"221","article-title":"A retrospective analysis of 1733 patients undergoing Total hip replacement for the first time for 10\u2009years in the third hospital of Hebei medical university","volume":"15","author":"Yang LX","year":"2014","journal-title":"Med Inform"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2019.12.004"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.03.014"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2018.11.002"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13639","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.13639","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T03:47:33Z","timestamp":1692330453000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/os.13639"],"URL":"https:\/\/doi.org\/10.1111\/os.13639","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]},"assertion":[{"value":"2022-08-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}