Government News
Risk prediction scoring aids treatment of patients 2024-04-07
After a 10-year research program, local medical experts have found that bone grafting treatment on young and middle-aged patients with osteonecrosis is effective and beneficial.
Osteonecrosis is blood flow to part of a bone is disrupted, resulting in death of bone tissue and leading to the bone's breakdown and the joint's collapse.
It can happen to any bone, but often develops in the ends of long bones, such as the thigh bone and upper arm bone. It is a common complicated disease in orthopedics.
The main treatment for osteonecrosis of femoral head is hip replacement.
Shanghai Sixth People's Hospital, the home of the National Center for Orthopedics, has been devoted in the research and practice on the issue. It has received a series of clinical achievements on evaluation, surgery and rehabilitation on hip-preserving treatment, according to Dr Zhang Changqing, director of the national center.
"The thigh is the longest bone in the body and is the support to standing, walking and mobility, so the head of femur is the joint easily hurt," Zhang said.
"Osteonecrosis of the femoral head mainly happens among people between 20 and 50 years old. For many young patients, their bones are still growing. It is better to preserve their femoral head and regain its proper function."
The study was published by world-leading journal Cell Press' iScience.
His team has used biological reconstruction in the past 20 years for hip-preservation treatment by using the patient's own fibula to repair the damaged femoral head.
So far, the team has carried out nearly 5,000 such bone grafting surgeries, becoming one of the largest hip-preserving centers in the world.
However, the identification and differentiation of appropriate indications of hip preserving with bone grafting therapy remains a challenge in the clinical practice.
Zhang's team conducted a cohort study on the therapy to evaluate hip survival rates, and to establish a risk scoring derived from potential risk factors for hip preservation.
Experts followed 854 hip-preserving cases the team has treated between mid 2001 and 2010 to study patients' outcomes.
They have established a model with eight variables being identified to form the world's first comprehensive risk scoring and hip-preserving evaluation and outcome forecast system. A total of 77.2 percent of the patients have their hips preserved after the surgery.
"This risk score outperforms conventional methods in forecasting hip preservation," he said.
"Bone grafting shows sustained benefits in treating the osteonecrosis of the femoral head when applied under the right indications. Furthermore, the risk scoring proves valuable as a decision-making tool, providing scientific guidance on hip-preserving treatment in the future."
The research "Development of a risk-predicting score for hip preservation with bone grafting therapy for osteonecrosis" was published by world-leading journal Cell Press' iScience.
Source: Shanghai Daily
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