LABORATORY AND ANIMAL STUDIES

The Relationship between Osteonecrosis of the Femoral Head and Alcohol Abuse
JD Chang
Department of Orthopaedic Surgery, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea

The purpose of the study is 1) to evaluate the relationship between osteonecrosis of the femoral head (ONFH) and alcohol abuse, 2) to define the patterns of the alcohol intake in the development of ONFH and 3) to define the risk factors in alcohol induced ONFH. 250 patients (333 hips) with ONFH diagnosed on the basis of histopathologic findings after total hip arthroplasty were analyzed. Among these patients, 169 patients who had a history of alcohol and idiopathic ONFH were selected as the case group. Two controls selected by a review of the orthopedic patient records were matched to each case (338 controls). From each patient and control, a detailed history of alcohol drinking, cigarette smoking, and herb medicine, weight, height, sGOT, sGPT and total cholesterol levels were obtained and analyzed. Statistical analysis was performed using the Generalized Linear Model including Chi-Square test, Fisher's exact test, ANOVA, and T-test. The adjusted relative odds ratio and 95 percent confidence interval (CI) were obtained using a conditional logistic regression model. We could confirm a direct relationship between alcohol abuse and ONFH. The amount of alcohol intake was more significant than duration of alcohol intake in the risk of the development of ONFH. The risk factors related with the patterns of alcohol consumption in the development of alcohol induced ONFH are as follows: 1) more than 4 times per week of alcohol intake, 2) more than 90 g of alcohol intake at one time, 3) more than 300 g of weekly alcohol intake, 4) more than 6000 of drink-years, 5) no side dishes. The other risk factors are smoking, low body mass index, and abnormal liver function tests.