Osteonecrosis of the head of femur in a Nigerian teaching hospital

Abstract

Objective: Osteonecrosis (ON) of the head of femur is not uncommon. The characteristics of affected patients and the associated aetiological factors in Nigeria are largely undocumented. To determine the epidemiological characteristics of patients with osteonecrosis of the head of femur, the radiological severity at presentation and associated aetiological risk factorsMethods: A retrospective study was done, of patients with femoral head ON seen between January 2013 and January 2019. Data on patients' characteristics, affected hips and radiological severity were entered onto a proforma and analysed.Results: There were 29 patients with ON of the head of femur involving 32 hips. There were 55.2% females and 44.8% male patients. While 3 (10.3%) patients had bilateral affectation, 26 (89.7%) had unilateral affectation. Their mean age is 26.6years 13.3. The mean age of male and female patients are 29.3 years and 24.3 years respectively. The mean BMI is 21.9 5.2 and no significant difference in the BMI of both genders, p=0.74. Ninety percent of them presented with advanced radiographic stages. Factors found to be associated with ON are sickle cell disease (SCD) 44.8%, trauma 13.8%, CVA 3.4% and idiopathic cases 37.7%. There is no significant difference in the frequency of unilateral and bilateral occurrence in the groups with different hemoglobin genotypes.Conclusions: Osteonecrosis of the head of femur occurs more often in young patients. They present late, with collapse of the head of femur. SCD, especially HbSS is the most common associated risk factor followed by idiopathic cases.
 Key words: Osteonecrosis, avascular necrosis, head of femur, sickle cell disease, risk factors

Evaluation of the Functions and Radiographic Severity of Osteonecrosis of the Head of Femur in South-west Nigeria

“…This is different from the slight female preponderance observed in a previous study of ONFH. [11] A male preponderance is the commonly reported pattern as currently observed. [9,12] The most crucial determinant of this pattern of sex prevalence is SCD, the most important aetiological factor in this cohort of patients.…”

“…The mean age of patients in this study (24.6 years) is consistent with the earlier report of 26.6 years. [11] The younger age contrasts with a mean age at presentation of 48.4years in Western Europe. [9] The patients in the study generally tended to be young adults, while those who specifically had sickle cell disease tended to be adolescents.…”

“…[10] These authors had previously reported that SCD was the aetiology of ONFH in 44.8% of all cases, irrespective of haemoglobin genotype. [11] Non-traumatic osteonecrosis is most common in productive young ages. Most patients are aged 30 to 40 years, [3,12] although patients as young as 20 years old are not uncommon.…”

Clinical emergency care quality indicators in Africa: a scoping review and data summary

“…In total, 39 studies were seen to contain ‘AFEM-CC quality indicators exact match’ data for process clinical and/or outcome quality indicators 18–56. Only 8% (3 of 39) of these studies explicitly mentioned quality in the stated research objectives.…”

“…The first group included 38 publications, which were identified as containing only ‘AFEM-CC quality indicators near match’ data 57–94. The second group included 15 publications, which were cited above as containing ‘AFEM-CC quality indicators exact match’ data, but which contained additional ‘AFEM-CC quality indicators near match’ data 22 25 26 28 29 31 33 34 39 41 45 46 54–56. This brings the total number of publications containing ‘AFEM-CC quality indicators near match’ data to 53 and the total number of data points identified within those publications to 87.…”