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Objectives: Alcohol intake and smoking are modifiable lifestyle-related risk factors for osteonecrosis of the femoral head (ONFH). We investigated geographic differences in ONFH incidence in Japan and the correlation with alcohol intake and smoking to develop prevention strategies for ONFH in Japan.
Methods: This ecological study was conducted in Japan primarily using the following data sources: nationwide epidemiological survey and national survey. We estimated the annual ONFH incidence and the prevalence of alcohol drinking and smoking in each prefecture. Prefectural incidence and prevalence were calculated by sex and age-standardization.
Results: The mean annual ONFH incidence per 100,000 population was 3.08 in men and 1.63 in women, respectively. There was no significant correlation between ONFH incidence and the prevalence of any levels of alcohol intake, while smoking ≥20 cigarettes/day showed a significant and moderate correlation in men (r = 0.47, p = .01). This correlation remained significant after adjustment for the prevalence of any levels of alcohol intake (standardized partial regression coefficient = 0.47-0.49, p = .009-.01).
Conclusion: ONFH incidence is geographically variable in Japan, and this may be partly explained by the distribution of smoking prevalence. Smoking cessation may contribute to an effective decline in the overall ONFH incidence in Japan.
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http://dx.doi.org/10.1080/14397595.2021.1899452 | DOI Listing |
J Hip Preserv Surg
July 2025
Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo 060-8638, Japan.
Osteonecrosis of the femoral head (ONFH) often leads to femoral head collapse, which makes joint preservation challenging. Although curved varus osteotomy (CVO) is an effective surgical method for joint preservation in young ONFH patients, there are some cases where it cannot prevent femoral head collapse. This research aims to evaluate the usefulness of teriparatide (TPD) in bone healing and preventing femoral head collapse in CVO-treated ONFH patients.
View Article and Find Full Text PDFJ Orthop Surg Res
August 2025
College of Sports Medicine and Rehabilitation, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, Shandong, China.
Background: Osteonecrosis of the femoral head (ONFH) is a progressive, debilitating orthopedic condition that primarily results from compromised vascular supply. Chronic alcohol intake is a well-established non-traumatic etiological factor in ONFH. Despite the increasing global research on ONFH, a bibliometric analysis using explicit literature searches in Web of Science reveals that no studies have specifically focused on alcohol-induced osteonecrosis of the femoral head (AONFH).
View Article and Find Full Text PDFPathophysiology
July 2025
Department of Pathological Anatomy, Medical Institute, Patrice Lumumba Peoples' Friendship University of Russia, 117198 Moscow, Russia.
Osteonecrosis of the femoral head (ONFH) is a common condition in hip surgery, which is characterized by the death of bone cells due to disruption of the blood supply and ultimately irreversible destruction of the hip joint. As a result of the COVID-19 pandemic, a significant increase in the incidence of ONFH has been identified. To better understand the pathogenesis of ONFH in the context of COVID-19, our research aimed to determine pathomorphological changes in articular tissues specific to post-COVID-19 ONFH.
View Article and Find Full Text PDFBone
July 2025
Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India. Electronic address:
Background: Osteonecrosis of the femoral head (ONFH) is a debilitating orthopaedic condition primarily affecting younger adults, often progressing to femoral head collapse and total hip replacement (THR). Stem cell therapy (SCT) has emerged as a regenerative option to delay disease progression and preserve joint function. This study aimed to evaluate efficacy of SCT, alone or in combination with mechanical support or bone grafting, in improving clinical outcomes in ONFH.
View Article and Find Full Text PDFJ Arthroplasty
June 2025
Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Background: Coronavirus disease 2019 (COVID-19) has been associated with systemic complications in addition to respiratory symptoms, including potential musculoskeletal disorders, such as osteonecrosis of the femoral head (ONFH). The aim of this study was to determine the difference between ONFH after COVID-19 and corticosteroid-associated ONFH using a large-scale ONFH database.
Methods: We analyzed 5,371 registered ONFH patients from a large multicenter Japanese database, identifying 20 patients (32 hips) who developed ONFH after COVID-19 (COVID-19 group).