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Current Trends of Osteonecrosis of the Femoral Head in Taiwan and China

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Osteonecrosis

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Abstract

Osteonecrosis of the femoral head (ONFH) is a disabling condition characterized by disruption of intravascular blood flow, direct cellular toxicity, and impaired mesenchymal cellular differentiation with subsequent bone death [1–3]. Collapse of the normal spherical head contour with progression to secondary arthritis occurs along a continuum of disease progression. There are an estimated 20,000–30,000 new cases of ONFH diagnosed annually in the USA, with the preponderance among young, active men between the ages of 20 and 50 years [4]. It is evident that ethnic differences in the index diagnosis for hip arthroplasty do exist. In a comparative study by Hoaglund, the incidence of ONFH as indication for THR in Japanese patients, an Asian population, was four times that of American Caucasian patients [5]. Therefore, because the population size of China, for example, is four and one-half times that of the USA, it is reasonable to conclude that there may be 360,000–540,000 new cases diagnosed in China annually. Osteoarthritis is the main indication for THRs performed in Caucasian populations [6], but ONFH is the main indication for hip arthroplasty in Asian populations. For instance, in Hong Kong, 45.6 % of THRs were performed under the diagnosis of ANFH [7], while only 3 % of THRs in the UK [8] and 10 % of THRs in the USA [9] are performed for ONFH. In addition, patients with ONFH are usually young men of working age; therefore, the socioeconomic impact of ONFH is great in Asian countries.

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Acknowledgments

We thank to the research staffs at the Center for Health Policy Research and Development, National Health Research Institutes, for their support in retrieving and cleaning data from the NHI database and to the staff at the Department of Health Services Administration, China Medical University, for data management.

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Authors and Affiliations

  1. Department of Orthopedics and Administration Center, Kuang-Tien General Hospital and Hung Kuang University, Taichung, Taiwan

    Fang-Tsai Lee

  2. Department of Health Services Administration, China Medical University, Taichung, Taiwan

    Tso-Chiang Ma

  3. Department of Orthopaedic Surgery, Chia-Yi Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5, Fu-Hsin Street, Kweishan, Taoyuan, 333, Taiwan

    Mel S. Lee

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  1. Fang-Tsai Lee
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Correspondence to Mel S. Lee .

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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Kyonggi-do, Korea, Republic of (South Korea)

    Kyung-Hoi Koo

  2. Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, USA

    Michael A. Mont

  3. Department of Orthopaedic Surgery, Department of Orthopaedic Surgery, Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Lynne C. Jones

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Lee, FT., Ma, TC., Lee, M.S. (2014). Current Trends of Osteonecrosis of the Femoral Head in Taiwan and China. In: Koo, KH., Mont, M., Jones, L. (eds) Osteonecrosis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35767-1_8

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  • DOI: https://doi.org/10.1007/978-3-642-35767-1_8

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