Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
4060118 | The Journal of Arthroplasty | 2015 | 12 Pages |
Abstract
The effect of varying corticosteroid regimens on hip osteonecrosis incidence remains unclear. We performed a meta-analysis and systematic literature review to determine osteonecrosis occurrences in patients taking corticosteroids at varying mean and cumulative doses and treatment durations, and whether medical diagnoses affected osteonecrosis incidence. Fifty-seven studies (23,561 patients) were reviewed. Regression analysis determined significance between corticosteroid usage and osteonecrosis incidence. Osteonecrosis incidence was 6.7% with corticosteroid treatment of >2Â g (prednisone-equivalent). Systemic lupus erythematosus patients had positive correlations between dose and osteonecrosis incidence. Each 10Â mg/d increase was associated with a 3.6% increase in osteonecrosis rate, and >20Â mg/d resulted in a higher osteonecrosis incidence. Clinicians must be wary of osteonecrosis in patients on high corticosteroid regimens, particularly in systematic lupus erythematosus.
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Authors
Michael A. M.D., Robert M.D., Samik M.D., Kimona M.D., Randa K. M.D., Lynne C. Ph.D.,