{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:38:40Z","timestamp":1793367520005,"version":"4.5.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J West Afr Coll Surg"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Glucocorticoid use and alcoholism constitute over 90% of all non-traumatic causes of avascular necrosis (AVN) of the head of the femur (HOF). Total hip arthroplasty (THA) is the treatment of choice for end-stage AVN of HOF. In Nigeria, patients use oral corticosteroids for many medical and social reasons. The purpose of this study was to analyse various reasons why steroids are used and to document the early outcomes of THA in steroid-induced osteonecrosis of HOF in northern Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This prospective interventional multicentre study was conducted at various government hospitals across northern Nigeria between January 2021 and June 2025. The reasons for taking steroids were documented in this study. The functional outcomes after THA were assessed using the Harris Hip Score (HHS), and patients\u2019 overall satisfaction was also reported using a 5-point Likert scale. Statistical analyses were performed using Statistical Package for the Social Sciences version 23 for Windows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Most of the patients, 102 (73.9%), use steroids for social reasons. Only 36 (26.1%) of the patients used the drugs for medical reasons. There was a significant improvement in postoperative HHS (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.000), and most of the patients were satisfied with the treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Most patients with steroid-induced AVN of HOF in northern Nigeria used steroids for social reasons. The outcome of THA for steroid-induced osteonecrosis of the HOF was excellent, and most patients were satisfied with the result.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jwas.jwas_154_25","type":"journal-article","created":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:02:05Z","timestamp":1793282525000},"page":"486-490","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Steroid-Induced Osteonecrosis of the Femoral Head in Northern Nigeria: Reasons for Steroid Use and Outcome of Total Hip Replacement"],"prefix":"10.4103","volume":"16","author":[{"given":"Mohammed Nuhu","family":"Salihu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University of Abuja Teaching Hospital, Federal Capital Territory, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soliudeen Adebayo","family":"Arojuraye","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, National Orthopaedic Hospital, Dala, Kano State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Musa","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rashid Shekoni Federal Teaching Hospital, Dutse, Jigawa State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Mohammed","family":"Ramat","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musliu Kolawole","family":"Odunola","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nigerian Army Reference Hospital, Kaduna, Kaduna State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"CIT0001-20261030","doi-asserted-by":"crossref","first-page":"449","DOI":"10.2174\/1874325001206010449","article-title":"Glucocorticoid-induced avascular bone necrosis: Diagnosis and management","volume":"6","author":"Chan","year":"2012","journal-title":"Open Orthop J"},{"key":"CIT0002-20261030","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1053\/sarh.2002.33724b","article-title":"Pathogenesis and natural history of osteonecrosis","volume":"32","author":"Assouline-Dayan","year":"2002","journal-title":"Semin Arthritis Rheum"},{"key":"CIT0003-20261030","doi-asserted-by":"crossref","first-page":"459","DOI":"10.2106\/00004623-199503000-00018","article-title":"Non-traumatic avascular necrosis of the femoral head","volume":"77","author":"Michael","year":"1995","journal-title":"J Bone Joint Surg Am"},{"key":"CIT0004-20261030","doi-asserted-by":"crossref","first-page":"455","DOI":"10.5435\/JAAOS-22-07-455","article-title":"Osteonecrosis of the femoral head: Evaluation and treatment","volume":"22","author":"Zalavras","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"key":"CIT0005-20261030","doi-asserted-by":"crossref","first-page":"250","DOI":"10.5435\/00124635-199907000-00005","article-title":"Osteonecrosis of the femoral head","volume":"7","author":"Lavernia","year":"1999","journal-title":"J Am Acad Orthop Surg"},{"key":"CIT0006-20261030","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.4103\/0366-6999.217094","article-title":"Corticosteroid-induced osteonecrosis of the femoral head: Detection, diagnosis, and treatment in earlier stages","volume":"130","author":"Liu","year":"2017","journal-title":"Chin Med J (Engl)"},{"key":"CIT0007-20261030","first-page":"1117","article-title":"Nontraumatic osteonecrosis of the femoral head: ten years later","volume":"88","author":"Mont","year":"2006","journal-title":"J Bone Joint Surg Am"},{"key":"CIT0008-20261030","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1007\/s12178-015-9290-y","article-title":"Total hip arthroplasty in the treatment of osteonecrosis of the femoral head: then and now","volume":"8","author":"Carlos","year":"2015","journal-title":"Curr Rev Musculoskelet Med"},{"key":"CIT0009-20261030","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0883-5403(99)90197-3","article-title":"Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up","volume":"14","author":"Ortiguera","year":"1999","journal-title":"J Arthroplasty"},{"key":"CIT0010-20261030","doi-asserted-by":"crossref","first-page":"474","DOI":"10.2106\/00004623-198365040-00007","article-title":"Total hip arthroplasties in patients less than forty-five years old","volume":"65","author":"Dorr","year":"1983","journal-title":"J Bone Joint Surg Am"},{"key":"CIT0011-20261030","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.2106\/00004623-198163090-00008","article-title":"Total hip replacement in patients younger than thirty years old. 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