{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T20:19:45Z","timestamp":1773605985315,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["23ZDYF2641"],"award-info":[{"award-number":["23ZDYF2641"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020207","name":"Health Commission of Sichuan Province","doi-asserted-by":"publisher","award":["2023\u2010118"],"award-info":[{"award-number":["2023\u2010118"]}],"id":[{"id":"10.13039\/501100020207","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>It is unclear whether less acetabular coverage is associated with the failure of core decompression (CD) for osteonecrosis of the femoral head (ONFH). This study aimed to investigate the clinical outcomes of CD for ONFH with small\u2010 or medium\u2010sized pre\u2010collapse lesions, and determine what factors, especially acetabular anatomical parameters, predict the failure of CD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between January 2010 and December 2022, we retrospectively reviewed 269 consecutive CDs in 188 patients diagnosed with ONFH with small\u2010 or medium\u2010sized pre\u2010collapse lesions. The Kaplan\u2013Meier method was used to evaluate the survival rate of CD for ONFH with progression of collapse or conversion to total hip arthroplasty (THA) as the endpoint. Univariate and multivariate logistic regression analyses were conducted to identify the potential risk factors for the failure of CD. Receiver operating characteristic (ROC) curve analysis was further performed with conversion to THA as the endpoint to determine the predictive value of these factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall 5\u2010year survival rate of CD for ONFH with small\u2010 or medium\u2010sized pre\u2010collapse lesions was 74.3% (95% confidence interval (CI) 69.0%\u201381.1%) with progression of collapse as the endpoint and 83.9% (95% CI 79.3%\u201388.7%) with conversion to THA as the endpoint. Univariate logistic regression analysis showed that bilateral affected hips was significantly associated with progression of collapse, and center\u2010edge angle (CEA), sharp angle, acetabular head index (AHI), as well as acetabular depth ratio (ADR) were significantly associated with both progression of collapse and conversion to THA. Multivariate logistic regression analysis further indicated that CEA and AHI were independent risk factors for both progression of collapse and conversion to THA. ROC curve analysis with conversion to THA as the endpoint revealed that the cutoff values for CEA and AHI were 26.8\u00b0 (sensitivity\u2009=\u200974.4%, specificity\u2009=\u200978.6%, area under the curve (AUC)\u2009=\u20090.809) and 79.8 (sensitivity\u2009=\u200978.4%, specificity\u2009=\u200973.8%, AUC\u2009=\u20090.818), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CD showed satisfactory clinical outcomes for ONFH with small\u2010 or medium\u2010sized pre\u2010collapse lesions where less acetabular coverage with a CEA\u2009&lt;\u200926.8\u00b0 or AHI\u2009&lt;\u200979.8 was identified as an independent risk factor for the failure of CD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.14094","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T01:41:38Z","timestamp":1715823698000},"page":"1614-1621","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Less Acetabular Coverage Predicts the Failure of Core Decompression for Osteonecrosis of the Femoral Head: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"16","author":[{"given":"Kai","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-8020","authenticated-orcid":false,"given":"Yi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hexi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research 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