Analysis of the natural collapse course of non-traumatic osteonecrosis of the femoral head based on the matrix model.

BACKGROUND: There are many predictions about the progression of natural collapse course of osteonecrosis of the femoral head. Here, we aimed to combine the three classical prediction methods to explore the progression of the natural collapse course. METHODS: This retrospective study included 127 patients admitted to our hospital from October 2016 to October 2017, in whom the femoral head had not collapsed. Logistic regression analysis was performed to determine the collapse risk factors, and Kaplan-Meier survival curves were used for femoral head survival analysis. The collapse rate of the femoral head was recorded within 5 years based on the matrix model. The specificity of the matrix model was analyzed using the receiver operating characteristic curve. RESULTS: A total of 127 patients with a total of 202 hips were included in this study, and 98 hips collapsed during the follow-up period. Multivariate logistics regression analysis showed that the predictive ability of the matrix model was stronger than Association Research Circulation Osseous staging, Japanese Investigation Committee classification, and area (P < 0.05). Kaplan-Meier survival curve showed that the median survival time of femoral head in patients was 3 years. The result of the receiver operating characteristic curve analysis showed that the area under the curve (AUC) of the matrix model had better predictive value (AUC = 0.771, log-rank test: P < 0.001). CONCLUSION: We creatively combined the three classical prediction methods for evaluating the progression of the natural collapse course based on the matrix model and found that the higher the score of the matrix model, the higher the femoral head collapse rate. Specifically, the matrix model has a potential value in predicting femoral head collapse and guiding treatment selection.

Hyperuricemia is associated with metabolic syndrome: A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES).

This study aimed to understand the prevalence of hyperuricemia and MetS in the United States and evaluate the potential effect of gender and ethnicity on hyperuricemia and MetS. Data was obtained from National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Logistic regression analysis was utilized to investigate the association between hyperuricemia and MetS. A total of 7273 participants with an average age of 47.59 ± 16.92 years old were enrolled in our analysis. Of all the people, 1833 were diagnosed with MetS, with which 547 (29.8 %) were found with hyperuricemia. As for gender, 261 (28.3 %) females were with both Mets and hyperuricemia and this number came to 286 (31.4 %) for males.For population distribution, Non-Hispanic American white, and Hispanic American making up 61.2 % of the cohort. The logistic regression analysis showed that there was a significant association between MetS and hyperuricemia (OR = 2.608, 95 %CI: 2.281-2.982). And the relationship still existed between both males (OR = 2.172, 95 %CI: 1.829-2.579) and females (OR = 3.464, 95 %CI: 2.868-4.185); in addition, participant's ethnicity was also found to play an important role. And the association was found either in Hispanic Americans Non-Hispanic Americans White and black or from other races. In conclusion, our study found a significant association between hyperuricemia and MetS. The higher the uric acid level, the greater risk of people getting MetS and this risk was not influenced by people's gender and ethnicity.

Return to work status of patients under 65 years of age with osteonecrosis of the femoral head after total hip arthroplasty.

OBJECTIVE: This aimed to evaluate the status of return to work (RTW) in patients with osteonecrosis of the femoral head (ONFH) after total hip arthroplasty (THA). METHODS: The baseline characteristics of all patients in this retrospective study were obtained from the hospital patient database. The relevant changes in patients' working conditions, as well as the numerical rating scale (NRS), Harris Hip Score (HHS), self-assessment of work ability, and Likert scale satisfaction assessment were obtained through video call follow-ups. RESULTS: 118 patients (response rate: 83%) were ultimately included in this study. The average length of time for the patients to stop working preoperatively was 20.7 weeks. Ninety-four patients (24 women and 70 men) who underwent THA had RTW status, with a mean RTW time of 21.0 weeks. Men had a significantly higher proportion of final RTW and a significantly faster RTW than women. Significant differences in smoking, drinking, cardiovascular diseases, changes in working levels, variations in the types of physical work, changes in working hours, and pain symptoms were observed between the RTW and Non-RTW populations. The patients with a positive RTW status had higher postoperative HHS scores, lower postoperative NRS scores, and higher self-assessment of work ability than patients who had a negative RTW status. CONCLUSION: Ultimately, 80% of patients achieved RTW status. Drinking, sex, change in working level, variation in the type of physical work, change in working hours, post-surgery HHS score and self-assessment of work ability can serve as predictive factors for RTW.