The influence of age, gender and treatment with steroids on the incidence of osteonecrosis of the femoral head during the management of severe acute respiratory syndrome: a retrospective study.
Corticosteroid use has been implicated in the development of osteonecrosis of the femoral head (ONFH). The exact mechanism and predisposing factors such as age, gender, dosage, type and combination of steroid treatment remain controversial. Between March and July 2003, a total of 539 patients with severe acute respiratory syndrome (SARS) were treated with five different types of steroid. There were 129 men (24%) and 410 women (76%) with a mean age of 33.7 years (21 to 59). Routine screening was undertaken with radiographs, MRI and/or CT to determine the incidence of ONFH. Of the 129 male patients with SARS, 51 (39.5%) were diagnosed as suffering from ONFH, compared with only 79 of 410 female patients (19.3%). The incidence of ONFH in the patients aged between 20 and 49 years was much higher than that of the group aged between 50 and 59 years (25.9% (127 of 491) versus 6.3% (3 of 48); p = 0.018). The incidence of ONFH in patients receiving one type of steroid was 12.5% (21 of 168), which was much lower than patients receiving two different types (28.6%; 96 of 336) or three different types of steroid (37.1%; 13 of 35).
Affiliated Hospital of Xuzhou Medical College, Department of Orthopedic Surgery, Xuzhou, Jiangsu 221002, China.
K J
KJ
Guo
F C
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Zhao
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Guo
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Li
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Zhu
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Zheng
D000328:Adult; D000367:Age Factors; D002681:China / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D013256:Steroids
Age; Femoral head; Gender; Osteonecrosis; SARS; Steroid