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 >2 g (prednisone-equivalent). Systemic lupus erythematosus patients had positive correlations between dose and osteonecrosis incidence. Each 10 mg/d increase was associated with a 3.6% increase in osteonecrosis rate, and >20 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.
Original language | English (US) |
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Pages (from-to) | 1506-1512.e5 |
Journal | Journal of Arthroplasty |
Volume | 30 |
Issue number | 9 |
DOIs | |
State | Published - Sep 1 2015 |
Keywords
- Corticosteroid
- Hip
- Meta-analysis
- Osteonecrosis
- Risk factors
ASJC Scopus subject areas
- Orthopedics and Sports Medicine