Related Experiment Video
Updated: Jun 15, 2025
Author Spotlight: Developing a Rat Model for Weight-Bearing Intervention to Investigate Osteonecrosis of the Femoral Head
Published on: September 27, 2024
Increasing Prevalence and Risk Factors for Multifocal Osteonecrosis in Patients Who Have Corticosteroid-Associated
Keiji Otaka1, Takashi Sakai2, Wakaba Fukushima3
1Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan.
Background:
Multifocal osteonecrosis (MFON) is a rare condition affecting multiple bone sites, with limited epidemiological data available. This study investigated the frequency, trends, and risk factors for MFON in patients aged > 15 years who had corticosteroid-associated osteonecrosis of the femoral head (ONFH) using data from a multicenter sentinel monitoring system in Japan.
Methods:
Data from 658 patients between 2009 and 2023 were analyzed. The MFON was defined as osteonecrosis involving three or more separate anatomical sites. The frequency and trends of MFON were assessed across three 5-year periods. The risk factors for MFON were analyzed using data from 2014 onward, when smoking history data became available. The group with no necrosis other than that in the femoral head was defined as the non-MFON group, and the demographics and comorbidities were compared between the MFON and non-MFON groups. The risk factors were analyzed using univariate and logistic regression analyses.
Results:
The frequency of MFON was 5.3% during the entire period and increased significantly over time (1.6, 7.4, and 8.0%; P < 0.01). The knee joint was the most common site of osteonecrosis, and all patients had knee joint involvement. The MFON group was younger (P < 0.001) and had more women (P < 0.05) than the non-MFON group and had significantly more patients who had systemic lupus erythematosus (SLE) and hematological tumors (both P < 0.01). The independent risk factors for MFON included age < 40 years (P < 0.05), SLE (P < 0.05), and hematological tumors (P < 0.001).
Conclusions:
The frequency of MFON in patients who had corticosteroid-associated osteonecrosis of the femoral head was 5.3%. Young patients, those who have SLE, or those who have hematological tumors are at a higher risk of MFON and should be considered for MFON screening.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:31Osteoclasts in Bone Remodeling
01:16Bones of the Lower Limb: Femur and Patella
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...