The 2019 Revised Version of Association Research Circulation Osseous Staging System of Osteonecrosis of the Femoral Head

The Association Research Circulation Osseous (ARCO) presents the 2019 revised staging system of osteonecrosis of the femoral head (ONFH) based on the 1994 ARCO classification. In October 2018, ARCO established a task force to revise the staging system of ONFH. The task force involved 29 experts who...

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Vydané v:The Journal of arthroplasty Ročník 35; číslo 4; s. 933 - 940
Hlavní autori: Yoon, Byung-Ho, Mont, Michael A., Koo, Kyung-Hoi, Chen, Chung-Hwan, Cheng, Edward Y., Cui, Quanjun, Drescher, Wolf, Gangji, Valerie, Goodman, Stuart B., Ha, Yong-Chan, Hernigou, Philippe, Hungerford, Marc W., Iorio, Richard, Jo, Woo-Lam, Jones, Lynne C., Khanduja, Vikas, Kim, Harry K.W., Kim, Shin-Yoon, Kim, Tae-Young, Lee, Hee Young, Lee, Mel S., Lee, Young-Kyun, Lee, Yun Jong, Nakamura, Junichi, Parvizi, Javad, Sakai, Takashi, Sugano, Nobuhiko, Takao, Masaki, Yamamoto, Takuaki, Zhao, De-Wei
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.04.2020
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ISSN:0883-5403, 1532-8406, 1532-8406
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Abstract The Association Research Circulation Osseous (ARCO) presents the 2019 revised staging system of osteonecrosis of the femoral head (ONFH) based on the 1994 ARCO classification. In October 2018, ARCO established a task force to revise the staging system of ONFH. The task force involved 29 experts who used a web-based survey for international collaboration. Content validity ratios for each answer were calculated to identify the levels of agreement. For the rating queries, a consensus was defined when more than 70% of the panel members scored a 4 or 5 rating on a 5-point scale. Response rates were 93.1%-100%, and through the 4-round Delphi study, the 1994 ARCO classification for ONFH was successfully revised. The final consensus resulted in the following 4-staged system: stage I—X-ray is normal, but either magnetic resonance imaging or bone scan is positive; stage II—X-ray is abnormal (subtle signs of osteosclerosis, focal osteoporosis, or cystic change in the femoral head) but without any evidence of subchondral fracture, fracture in the necrotic portion, or flattening of the femoral head; stage III—fracture in the subchondral or necrotic zone as seen on X-ray or computed tomography scans. This stage is further divided into stage IIIA (early, femoral head depression ≤2 mm) and stage IIIB (late, femoral head depression >2 mm); and stage IV—X-ray evidence of osteoarthritis with accompanying joint space narrowing, acetabular changes, and/or joint destruction. This revised staging system does not incorporate the previous subclassification or quantitation parameters, but the panels agreed on the future development of a separate grading system for predicting disease progression. A staging system has been developed to revise the 1994 ARCO classification for ONFH by an expert panel-based Delphi survey. ARCO approved and recommends this revised system as a universal staging of ONFH.
AbstractList The Association Research Circulation Osseous (ARCO) presents the 2019 revised staging system of osteonecrosis of the femoral head (ONFH) based on the 1994 ARCO classification.BACKGROUNDThe Association Research Circulation Osseous (ARCO) presents the 2019 revised staging system of osteonecrosis of the femoral head (ONFH) based on the 1994 ARCO classification.In October 2018, ARCO established a task force to revise the staging system of ONFH. The task force involved 29 experts who used a web-based survey for international collaboration. Content validity ratios for each answer were calculated to identify the levels of agreement. For the rating queries, a consensus was defined when more than 70% of the panel members scored a 4 or 5 rating on a 5-point scale.METHODSIn October 2018, ARCO established a task force to revise the staging system of ONFH. The task force involved 29 experts who used a web-based survey for international collaboration. Content validity ratios for each answer were calculated to identify the levels of agreement. For the rating queries, a consensus was defined when more than 70% of the panel members scored a 4 or 5 rating on a 5-point scale.Response rates were 93.1%-100%, and through the 4-round Delphi study, the 1994 ARCO classification for ONFH was successfully revised. The final consensus resulted in the following 4-staged system: stage I-X-ray is normal, but either magnetic resonance imaging or bone scan is positive; stage II-X-ray is abnormal (subtle signs of osteosclerosis, focal osteoporosis, or cystic change in the femoral head) but without any evidence of subchondral fracture, fracture in the necrotic portion, or flattening of the femoral head; stage III-fracture in the subchondral or necrotic zone as seen on X-ray or computed tomography scans. This stage is further divided into stage IIIA (early, femoral head depression ≤2 mm) and stage IIIB (late, femoral head depression >2 mm); and stage IV-X-ray evidence of osteoarthritis with accompanying joint space narrowing, acetabular changes, and/or joint destruction. This revised staging system does not incorporate the previous subclassification or quantitation parameters, but the panels agreed on the future development of a separate grading system for predicting disease progression.RESULTSResponse rates were 93.1%-100%, and through the 4-round Delphi study, the 1994 ARCO classification for ONFH was successfully revised. The final consensus resulted in the following 4-staged system: stage I-X-ray is normal, but either magnetic resonance imaging or bone scan is positive; stage II-X-ray is abnormal (subtle signs of osteosclerosis, focal osteoporosis, or cystic change in the femoral head) but without any evidence of subchondral fracture, fracture in the necrotic portion, or flattening of the femoral head; stage III-fracture in the subchondral or necrotic zone as seen on X-ray or computed tomography scans. This stage is further divided into stage IIIA (early, femoral head depression ≤2 mm) and stage IIIB (late, femoral head depression >2 mm); and stage IV-X-ray evidence of osteoarthritis with accompanying joint space narrowing, acetabular changes, and/or joint destruction. This revised staging system does not incorporate the previous subclassification or quantitation parameters, but the panels agreed on the future development of a separate grading system for predicting disease progression.A staging system has been developed to revise the 1994 ARCO classification for ONFH by an expert panel-based Delphi survey. ARCO approved and recommends this revised system as a universal staging of ONFH.CONCLUSIONA staging system has been developed to revise the 1994 ARCO classification for ONFH by an expert panel-based Delphi survey. ARCO approved and recommends this revised system as a universal staging of ONFH.
The Association Research Circulation Osseous (ARCO) presents the 2019 revised staging system of osteonecrosis of the femoral head (ONFH) based on the 1994 ARCO classification. In October 2018, ARCO established a task force to revise the staging system of ONFH. The task force involved 29 experts who used a web-based survey for international collaboration. Content validity ratios for each answer were calculated to identify the levels of agreement. For the rating queries, a consensus was defined when more than 70% of the panel members scored a 4 or 5 rating on a 5-point scale. Response rates were 93.1%-100%, and through the 4-round Delphi study, the 1994 ARCO classification for ONFH was successfully revised. The final consensus resulted in the following 4-staged system: stage I-X-ray is normal, but either magnetic resonance imaging or bone scan is positive; stage II-X-ray is abnormal (subtle signs of osteosclerosis, focal osteoporosis, or cystic change in the femoral head) but without any evidence of subchondral fracture, fracture in the necrotic portion, or flattening of the femoral head; stage III-fracture in the subchondral or necrotic zone as seen on X-ray or computed tomography scans. This stage is further divided into stage IIIA (early, femoral head depression ≤2 mm) and stage IIIB (late, femoral head depression >2 mm); and stage IV-X-ray evidence of osteoarthritis with accompanying joint space narrowing, acetabular changes, and/or joint destruction. This revised staging system does not incorporate the previous subclassification or quantitation parameters, but the panels agreed on the future development of a separate grading system for predicting disease progression. A staging system has been developed to revise the 1994 ARCO classification for ONFH by an expert panel-based Delphi survey. ARCO approved and recommends this revised system as a universal staging of ONFH.
Author Yoon, Byung-Ho
Koo, Kyung-Hoi
Khanduja, Vikas
Sugano, Nobuhiko
Gangji, Valerie
Goodman, Stuart B.
Nakamura, Junichi
Hernigou, Philippe
Cui, Quanjun
Takao, Masaki
Cheng, Edward Y.
Iorio, Richard
Kim, Harry K.W.
Sakai, Takashi
Mont, Michael A.
Yamamoto, Takuaki
Lee, Hee Young
Lee, Young-Kyun
Jones, Lynne C.
Jo, Woo-Lam
Parvizi, Javad
Kim, Shin-Yoon
Lee, Yun Jong
Hungerford, Marc W.
Drescher, Wolf
Kim, Tae-Young
Lee, Mel S.
Zhao, De-Wei
Chen, Chung-Hwan
Ha, Yong-Chan
Author_xml – sequence: 1
  givenname: Byung-Ho
  surname: Yoon
  fullname: Yoon, Byung-Ho
  organization: Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea
– sequence: 2
  givenname: Michael A.
  surname: Mont
  fullname: Mont, Michael A.
  organization: Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY
– sequence: 3
  givenname: Kyung-Hoi
  orcidid: 0000-0001-5251-2911
  surname: Koo
  fullname: Koo, Kyung-Hoi
  organization: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
– sequence: 4
  givenname: Chung-Hwan
  surname: Chen
  fullname: Chen, Chung-Hwan
  organization: Department of Orthopaedic Surgery, Kaoshiung Medical University Hospital, Kaohsiung, Taiwan
– sequence: 5
  givenname: Edward Y.
  surname: Cheng
  fullname: Cheng, Edward Y.
  organization: Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, MN
– sequence: 6
  givenname: Quanjun
  surname: Cui
  fullname: Cui, Quanjun
  organization: Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA
– sequence: 7
  givenname: Wolf
  surname: Drescher
  fullname: Drescher, Wolf
  organization: Department of Orthopedic and Trauma Surgery, RWTH Aachen University, Aachen, Germany
– sequence: 8
  givenname: Valerie
  surname: Gangji
  fullname: Gangji, Valerie
  organization: Department of Rheumatology and Physical Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
– sequence: 9
  givenname: Stuart B.
  surname: Goodman
  fullname: Goodman, Stuart B.
  organization: Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
– sequence: 10
  givenname: Yong-Chan
  surname: Ha
  fullname: Ha, Yong-Chan
  organization: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
– sequence: 11
  givenname: Philippe
  surname: Hernigou
  fullname: Hernigou, Philippe
  organization: Hôpital Henri Mondor, Creteil, France
– sequence: 12
  givenname: Marc W.
  surname: Hungerford
  fullname: Hungerford, Marc W.
  organization: Department of Orthopedic Surgery, Mercy Medical Center, Baltimore, MD
– sequence: 13
  givenname: Richard
  surname: Iorio
  fullname: Iorio, Richard
  organization: Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA
– sequence: 14
  givenname: Woo-Lam
  surname: Jo
  fullname: Jo, Woo-Lam
  organization: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
– sequence: 15
  givenname: Lynne C.
  surname: Jones
  fullname: Jones, Lynne C.
  organization: Department of Orthopaedic Surgery, Center for Metabolism and Obesity Research, Johns Hopkins, University School of Medicine, Baltimore, MD
– sequence: 16
  givenname: Vikas
  surname: Khanduja
  fullname: Khanduja, Vikas
  organization: Department of Trauma & Orthopaedics, Addenbrooke's, Cambridge University Hospitals, Cambridge, UK
– sequence: 17
  givenname: Harry K.W.
  surname: Kim
  fullname: Kim, Harry K.W.
  organization: Center for Excellence in Hip Disorders, Scottish Rite Hospital for Children, UT Southwestern Medical Center, Dallas, TX
– sequence: 18
  givenname: Shin-Yoon
  surname: Kim
  fullname: Kim, Shin-Yoon
  organization: Department of Orthopedic Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea
– sequence: 19
  givenname: Tae-Young
  surname: Kim
  fullname: Kim, Tae-Young
  organization: Department of Orthopedic Surgery, KonKuk University Medical Center, Seoul, South Korea
– sequence: 20
  givenname: Hee Young
  surname: Lee
  fullname: Lee, Hee Young
  organization: Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, South Korea
– sequence: 21
  givenname: Mel S.
  surname: Lee
  fullname: Lee, Mel S.
  organization: Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
– sequence: 22
  givenname: Young-Kyun
  surname: Lee
  fullname: Lee, Young-Kyun
  organization: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
– sequence: 23
  givenname: Yun Jong
  surname: Lee
  fullname: Lee, Yun Jong
  organization: Department of Internal Medicine, Seoul National University Bundang Hospital and Medical College of Seoul National University, Seongnam, South Korea
– sequence: 24
  givenname: Junichi
  surname: Nakamura
  fullname: Nakamura, Junichi
  organization: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan
– sequence: 25
  givenname: Javad
  surname: Parvizi
  fullname: Parvizi, Javad
  organization: Department of Orthopedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA
– sequence: 26
  givenname: Takashi
  surname: Sakai
  fullname: Sakai, Takashi
  organization: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan
– sequence: 27
  givenname: Nobuhiko
  surname: Sugano
  fullname: Sugano, Nobuhiko
  organization: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
– sequence: 28
  givenname: Masaki
  surname: Takao
  fullname: Takao, Masaki
  organization: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan
– sequence: 29
  givenname: Takuaki
  surname: Yamamoto
  fullname: Yamamoto, Takuaki
  organization: Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan
– sequence: 30
  givenname: De-Wei
  surname: Zhao
  fullname: Zhao, De-Wei
  organization: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31866252$$D View this record in MEDLINE/PubMed
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Issue 4
Keywords osteonecrosis
avascular necrosis
staging
Delphi
hip
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Snippet The Association Research Circulation Osseous (ARCO) presents the 2019 revised staging system of osteonecrosis of the femoral head (ONFH) based on the 1994 ARCO...
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SubjectTerms avascular necrosis
Delphi
Femur Head - diagnostic imaging
Femur Head Necrosis - diagnostic imaging
hip
Humans
Magnetic Resonance Imaging
osteonecrosis
Radiography
staging
Tomography, X-Ray Computed
Title The 2019 Revised Version of Association Research Circulation Osseous Staging System of Osteonecrosis of the Femoral Head
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0883540319311015
https://dx.doi.org/10.1016/j.arth.2019.11.029
https://www.ncbi.nlm.nih.gov/pubmed/31866252
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Volume 35
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