Authors
Dewei Zhao, Jiawei Ying
Published in
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery. Volume 40. Issue 10. Pages 1469-1473. Oct 15, 2026.
Abstract
Nontraumatic osteonecrosis of the femoral head (ONFH) predominantly affects young and middle-aged adults and carries a high risk of disability. Substantial variations exist in diagnostic and treatment strategies worldwide, and unified evidence-based standards have been lacking. In April 2026, the Association Research Circulation Osseous (ARCO) published the first international multidisciplinary evidence-based clinical practice guideline for nontraumatic ONFH. Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the guideline formulated 12 standardized recommendations for diagnosis and treatment. One of the authors participated throughout the guideline-development process as a member of the Chinese working group. This article interprets all 12 recommendations and compares international and Chinese diagnostic and treatment strategies in the context of existing Chinese guidelines and clinical practice. It also examines limitations in the available evidence and proposes approaches for implementing the recommendations in China, thereby providing an evidence-based reference for standardized staging, hip-preserving treatment, and individualized decision-making between joint preservation and arthroplasty for patients with nontraumatic ONFH.
PMID:
42896984
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.
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