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Incidence and risk factors for osteonecrosis of the femoral head in five hundred and ten sickle cell disease paediatric patients.
Ouederni, Monia; Rouag, Hatem; Ben Fraj, Ilhem; Rekaya, Samia; Kouki, Ridha; Lamouchi, Takwa; Zaiter, Ikram; Mellouli, Fethi; Bejaoui, Mohamed; Ben Khaled, Monia.
Afiliação
  • Ouederni M; Department of Pediatrics- Immunohematology and Stem Cell Transplantation, National Center of Bone Marrow Transplant, 02 Street Jbel Lakhdhar, Bab Saadoun, Tunis, Tunisia. ouederni.moni@gmail.com.
  • Rouag H; Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. ouederni.moni@gmail.com.
  • Ben Fraj I; Department of Pediatrics- Immunohematology and Stem Cell Transplantation, National Center of Bone Marrow Transplant, 02 Street Jbel Lakhdhar, Bab Saadoun, Tunis, Tunisia.
  • Rekaya S; Department of Pediatrics- Immunohematology and Stem Cell Transplantation, National Center of Bone Marrow Transplant, 02 Street Jbel Lakhdhar, Bab Saadoun, Tunis, Tunisia.
  • Kouki R; Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
  • Lamouchi T; Department of Pediatrics- Immunohematology and Stem Cell Transplantation, National Center of Bone Marrow Transplant, 02 Street Jbel Lakhdhar, Bab Saadoun, Tunis, Tunisia.
  • Zaiter I; Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
  • Mellouli F; Department of Pediatrics- Immunohematology and Stem Cell Transplantation, National Center of Bone Marrow Transplant, 02 Street Jbel Lakhdhar, Bab Saadoun, Tunis, Tunisia.
  • Bejaoui M; Department of Pediatrics- Immunohematology and Stem Cell Transplantation, National Center of Bone Marrow Transplant, 02 Street Jbel Lakhdhar, Bab Saadoun, Tunis, Tunisia.
  • Ben Khaled M; Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
Int Orthop ; 47(12): 2941-2952, 2023 Dec.
Article em En | MEDLINE | ID: mdl-37452863
ABSTRACT

PURPOSE:

Osteonecrosis of the femoral head (ONFH) is a degenerative and progressive disorder that mainly affects people with sickle cell disease (SCD). Herein, we aimed to search for a better understanding of markers that can act as risk factors for ONFH in patients with SCD.

METHODS:

We conducted a retrospective study including 510 SCD patients followed over 23 years. Patients were divided into the ONFH group and the no-ONHF control group. Univariate and multivariate logistic regression analyses were performed to identify risk factors.

RESULTS:

Among 510 SCD patients, 41(8%) were diagnosed with ONFH at a mean age of 167 months ± 64 (72-288). The cumulative incidence of ONHF increased from 2.3% at ten years to 18.3% at 20 years of age. The radiological grade 3 ONHF was predominant. No significant differences in sex, age at diagnosis of SCD, and Hb genotype were found between groups. The patient age and the time since diagnosis of SCD were statistically higher in patients with ONHF in univariate and multivariate analysis. ONHF was also associated with higher creatinine level (p = 0.001) lower LDH level (p = 0.006), and higher number of vaso-occlusive crisis (VOC)/patient/year (p < 0.001). The cumulative incidence of ONHF in patients having more than 3 VOC/year was significantly higher (43% versus 18.9% at 20 years, p < 0.001). In addition, infections, gallstones, growth delay, delayed initiation of hydroxyurea, and a higher transfusion rate were significantly associated with ONFH.

CONCLUSION:

These findings confirm that ONFH is closely related to the age, severity, and duration of SCD. Better management of this disease prevents acute and chronic complications, and early screening of the ONFH as soon as the first signs of the severity of the disease are detected provides a better functional prognosis.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Compostos Orgânicos Voláteis / Necrose da Cabeça do Fêmur / Anemia Falciforme Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Compostos Orgânicos Voláteis / Necrose da Cabeça do Fêmur / Anemia Falciforme Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article