Descriptive and Analytic Epidemiology of Idiopathic Osteonecrosis of the Femoral Head in Japan
Idiopathic osteonecrosis of the femoral head (ONFH) is a rare and multifactorial disease, which involves noninfectious and ischemic pathogenesis. ONFH has been designated as one of the targeted intractable diseases by the Ministry of Health, Labour and Welfare (MHLW) in Japan and its medical cost for treatment has been subsidized by public expenditure. Together with these policies, the epidemiology of ONFH in Japan has also been systematically elucidated by the Study Group on ONFH with academic support from the Study Group on Epidemiologic Research for Intractable Diseases (ERID), both of which are funded by the MHLW. This chapter summarizes the findings of descriptive and analytic epidemiology on ONFH which have been accumulated through collaborative efforts of the ONFH Study Group and the ERID Study Group. Methodologies in these epidemiologic studies include a nationwide epidemiologic survey and a hospital-based sentinel monitoring system to assess frequency and distribution of ONFH. Furthermore, case-control and cohort studies have been conducted to evaluate systemic steroid use and alcohol intake as two major risk factors for ONFH.
KeywordsOsteonecrosis Femoral head Epidemiology Steroid Alcohol
- 4.Hirota Y, Hotokebuchi T, Sugioka Y. Idiopathic osteonecrosis of the femoral head: nationwide epidemiologic studies in Japan. In: Urbaniak JR, Jones Jr JP, editors. Osteonecrosis -- etiology, diagnosis and treatment. Rosemont: American Academy of Orthopaedic surgeons; 1997. p. 51–8.Google Scholar
- 9.Nakamura Y. [A manual of a nationwide epidemiologic survey for estimating the number of patients and assessing clinico-epidemiological characteristics of patients with intractable diseases (3rd edition)] [in Japanese]. The Study Group on Epidemiologic Research for Intractable Diseases. 2017. http://www.jichi.ac.jp/dph/nanbyou/manual_2017.pdf. Accessed 31 Oct 2017.
- 10.Aoki R, Ohno Y, Tamakoshi A, Kawamura T, Wakai K, Senda M, Lin YS, Ninomiya S, Hirota Y, Igarashi Y, Hashimoto S, Aizawa S, Minowa M, Inaba Y. [Nationwide epidemiological survey on idiopathic osteonecrosis of the femoral head in Japan] [in Japanese]. Tokyo: The Annual Report of the Study Group on Epidemiologic Research for Intractable Diseases in the fiscal year of 1995, Ministry of Health of Japan.; 1996. p. 67–72.Google Scholar
- 12.Fukushima W, Sakai T, Nakamura Y, Sugano N. [Nationwide epidemiologic survey on idiopathic osteonecrosis of the femoral head in Japan] [in Japanese]. Tokyo: The Annual Report of the Study Group on Idiopathic Osteonecrosis of the Femoral Head in the fiscal year of 2016, Ministry of Health and Welfare of Japan. 2017. http://mhlw-grants.niph.go.jp/niph/search/NIDD00.do?resrchNum=201610024B. Accessed 31 Oct 2017.
- 15.Takahashi S, Fukushima W, Yamamoto T, Iwamoto Y, Kubo T, Sugano N, Hirota Y. Japanese sentinel monitoring study Group for Idiopathic Osteonecrosis of the femoral head. Temporal trends in characteristics of newly diagnosed nontraumatic osteonecrosis of the femoral head from 1997 to 2011: a hospital-based sentinel monitoring system in Japan. J Epidemiol. 2015;25:437–44.CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Japan Intractable Diseases Information Center: The number of cases of intractable diseases in Japan [in Japanese]. http://www.nanbyou.or.jp/entry/1356. Accessed 31 Oct 2017.
- 17.Japan Organ Transplant Network: Donors and Transplants Data. http://www.jotnw.or.jp/english/data.html. Accessed 31 Oct 2017.
- 21.Matsuo K, Hirohata T, Sugioka Y, Ikeda M, Fukuda A. Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res. 1988;234:115–23.Google Scholar
- 27.Ohzono K, Lee K, Ando W, Takao M, Sugano N, Nishii T, Hirota Y. Predictors for corticosteroid associated osteonecrosis of the femoral head among patients with sustemic lupus erythematosus [in Japanese]. Riumachika. 2002;27:114–7.Google Scholar
- 29.Shibatani M, Fujioka M, Arai Y, Takahashi K, Ueshima K, Okamoto M, Yoshimura N, Hirota Y, Fukushima W, Kubo T. Degree of corticosteroid treatment within the first 2 months of renal transplantation has a strong influence on the incidence of osteonecrosis of the femoral head. Acta Orthop. 2008;79:631–6.CrossRefPubMedGoogle Scholar
- 31.Sakaguchi M, Tanaka T, Fukushima W, Kubo T, Hirota Y. Idiopathic ONF Multicenter Case-Control Study Group. Impact of oral corticosteroid use for idiopathic osteonecrosis of the femoral head: a nationwide multicenter case-control study in Japan. J Orthop Sci. 2010;15:185–91.CrossRefPubMedGoogle Scholar