解放军医学杂志2024，Vol.49Issue(11)：1272-1280,9.DOI:10.11855/j.issn.0577-7402.0534.2023.1130
同种异体腓骨植骨术后股骨头早期塌陷进展的影响因素及其预测价值
Factors influencing early collapse progression of the femoral head after allogenic fibula grafting and their predictive value
摘要
Abstract
Objective To explore the influential factors and predictive value of early femoral head collapse progression following allogeneic fibula grafting(AFG)surgery.Methods Clinical and radiological data of 68 patients(75 hips)with osteonecrosis of the femoral head(ONFH)who underwent AFG between January 2008 and December 2022 at the Orthopedics and Traumatology Department,Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed.Seventy-five hips were divided into stable(n=40)and progressive(n=35)groups based on the presence or absence of postoperative collapse progression.Age,gender,etiology,location of the lesion,Association Research Circulation Osseous(ARCO)stage,Japanese Committee of Osteonecrosis Investigation(JIC)classification,China-Japan Friendship Hospital(CJFH)classification,and Hounsfield units(HU)value of anterolateral sclerosis rim(ⅠSHU)were collected.Univariate and multivariate logistic regression analyses were used to identify the factors influencing early collapse progression after AFG.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the identified factors influencing postoperative early collapse progression.Results Of the 75 hips,35(46.7%)had postoperative collapse progression.Univariate logistic regression analysis showed that age,ARCO stage,JIC classification,and ⅠSHU were in fluencing factors for early femoral head collapse progression after AFG(P<0.05).Multivariate logistic regression analysis showed that ARCO stage ⅢA and JIC classification C2 were independent risk factors for early femoral head collapse progression after AFG,while ⅠSHU was identified as an independent protective factor(P<0.05).The ROC curve analysis showed that the sensitivities of ARCO stage,JIC classification,ⅠSHU,and the combined predictive model were 0.850,0.725,0.800,and 0.775,the specificities were 0.486,0.657,0.743,and 0.914,and the area under the ROC curve(AUC)were 0.668,0.725,0.811,and 0.896,respectively.Conclusions ⅠSHU is associated with early collapse progression after AFG in patients with ONFH.ARCO stage ⅢA,JIC classification C2,and ⅠSHU are independent factors influencing postoperative early collapse progression and have a certain predictive value.关键词
股骨头坏死/硬化带/异体腓骨植骨术/影响因素Key words
femoral head osteonecrosis/sclerosis rim/allogeneic fibula grafting/influential factors分类
医药卫生引用本文复制引用
黄艺轩,郭铭滨,麦健斌,袁鑫玮,席洪钟,宋伟,杜斌,刘锌..同种异体腓骨植骨术后股骨头早期塌陷进展的影响因素及其预测价值[J].解放军医学杂志,2024,49(11):1272-1280,9.基金项目
This work was supported by the General Program of National Natural Science Foundation of China(82074471),and the Youth Fund of National Natural Science Foundation of China(81804117) 国家自然科学基金面上项目(82074471) （82074471）
国家自然科学基金青年基金(81804117) （81804117）
