| Metric | Population/setting | Value | Timeframe | Notes | Source (first author year, journal) | URL |
|---|---|---:|---|---|---|---|
| Prevalence | United States, osteonecrosis/ONFH | 300,000–600,000 affected individuals | Not specified | Reported as U.S. prevalence in a 2024 review focused on steroid-induced ONFH (pqac-00000003) | Li 2024, *Annals of Medicine* | https://doi.org/10.1080/07853890.2024.2416070 |
| New cases/year | United States, osteonecrosis/ONFH | 10,000–20,000 new cases/year | Annual | Reported in recent ONFH review; lower U.S. estimate than older reviews (pqac-00000003, pqac-00000028) | Li 2024, *Annals of Medicine* | https://doi.org/10.1080/07853890.2024.2416070 |
| New cases/year | United States, ONFH | 20,000–30,000 new cases/year | Annual | Frequently cited benchmark in reviews and imaging/epidemiology overviews (pqac-00000009, pqac-00000014, pqac-00000029) | Moya-Angeler 2015, *World Journal of Orthopedics* | https://doi.org/10.5312/wjo.v6.i8.590 |
| Incidence | Japan, ONFH | 1.91/100,000 | Annual | Reported alongside national case counts in 2024 review (pqac-00000003) | Li 2024, *Annals of Medicine* | https://doi.org/10.1080/07853890.2024.2416070 |
| New cases/year | Japan, ONFH | 2,500–3,300 new cases/year | Annual | National estimate cited in recent review (pqac-00000003) | Li 2024, *Annals of Medicine* | https://doi.org/10.1080/07853890.2024.2416070 |
| Affected population | China, ONFH | >8 million patients | Contemporary estimate | Large disease burden repeatedly cited in recent reviews (pqac-00000002, pqac-00000003) | Li 2024, *Annals of Medicine* | https://doi.org/10.1080/07853890.2024.2416070 |
| New cases/year | China, ONFH | 50,000–100,000 new cases/year | Annual | Prognostic modeling paper estimate (pqac-00000008) | Yang 2024, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-024-05247-0 |
| Incidence | Asia, ONFH | 1.91–5.0 per 10,000 individuals | Not specified | Reported in bibliometric review summarizing prior epidemiology sources (pqac-00000013) | Pang 2025, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-025-06138-8 |
| Progression/collapse risk | Untreated ONFH | >80% progress to femoral head collapse | Within 2 years | Reported for patients without early intervention in recent pathogenesis review (pqac-00000002) | Zhang 2024, *Biomolecules* | https://doi.org/10.3390/biom14060667 |
| Progression/collapse risk | Untreated ONFH | >80% progress to collapse and arthritis | Not specified | Similar natural-history estimate in nationwide U.S. trends paper (pqac-00000031) | Ng 2023, *Arthroplasty* | https://doi.org/10.1186/s42836-023-00176-5 |
| Post-traumatic incidence | Adolescents after femoral neck fracture surgery | 24.02% (95% CI 21.18%–27.12%) | Postoperative follow-up across studies | Meta-analysis of 17 studies, n=862 adolescents (pqac-00000005) | Gu 2024, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-024-05275-w |
| Surgical management proportion | U.S. ONFH patients receiving hip surgery | THA 94.97%; core decompression 3.20%; hemiarthroplasty/resurfacing 0.99%; bone grafting 0.46%; osteotomy 0.05% | 2010–2019 | Nationwide database study of 10,334 surgically treated patients (pqac-00000031) | Ng 2023, *Arthroplasty* | https://doi.org/10.1186/s42836-023-00176-5 |
| Arthroplasty burden | ONFH among all THAs in U.S. | ~10% of total hip arthroplasties | Annual | Longstanding benchmark repeated in reviews (pqac-00000029, pqac-00000028) | Moya-Angeler 2015, *World Journal of Orthopedics* | https://doi.org/10.5312/wjo.v6.i8.590 |
| Mean age | AVN/ONFH hip cohort undergoing MRI staging | 41.2 years (range 20–63) | Study period 2 years | Descriptive MRI study, 50 patients/80 hips (pqac-00000014) | Rohilla 2025, *Cureus* | https://doi.org/10.7759/cureus.86867 |
| Sex ratio | AVN/ONFH hip MRI cohort | Male 62%; male:female ratio 1.63:1 | Study period 2 years | Same cohort showed male predominance (pqac-00000014) | Rohilla 2025, *Cureus* | https://doi.org/10.7759/cureus.86867 |
| Bilaterality | AVN/ONFH hip MRI cohort | 60% bilateral involvement | Cross-sectional cohort | 30/50 cases bilateral; 22% right unilateral; 18% left unilateral (pqac-00000014) | Rohilla 2025, *Cureus* | https://doi.org/10.7759/cureus.86867 |
| Symptom frequency | AVN/ONFH hip MRI cohort | Hip pain in 86% | Cross-sectional cohort | 43/50 cases reported hip pain (pqac-00000014) | Rohilla 2025, *Cureus* | https://doi.org/10.7759/cureus.86867 |
| ARCO stage distribution | AVN/ONFH hip MRI cohort (80 hips) | Stage I 13.75%; II 23.75%; IIIA 26.25%; IIIB 10%; IV 26.25% | Cross-sectional cohort | Demonstrates mixed pre- and post-collapse disease at presentation (pqac-00000014) | Rohilla 2025, *Cureus* | https://doi.org/10.7759/cureus.86867 |
| Glucocorticoid etiologic threshold | ARCO glucocorticoid-associated ONFH research classification | >2 g prednisolone-equivalent | Within 3 months | Must also be diagnosed within 2 years of exposure and have no other major risk factor (pqac-00000019, pqac-00000020, pqac-00000021) | Yoon 2019, *Journal of Arthroplasty* | https://doi.org/10.1016/j.arth.2018.09.005 |
| Alcohol etiologic threshold | ARCO alcohol-associated ONFH research classification | >320 g/week alcohol (>400 mL/week ethanol-containing consumption as summarized) | Diagnosis within 1 year of such consumption | No other major risk factor; threshold summarized in Ko 2023 review of ARCO criteria (pqac-00000016) | Ko 2023, *Hip & Pelvis* | https://doi.org/10.5371/hp.2023.35.3.147 |
| Daily glucocorticoid dose effect | Glucocorticoid-exposed patients | +4.6% ONFH rate per additional 10 mg/day; OR 4.2 for daily dose >40 mg | Exposure-related | Dose-response summarized in ARCO etiologic consensus (pqac-00000019) | Yoon 2019, *Journal of Arthroplasty* | https://doi.org/10.1016/j.arth.2018.09.005 |
| Early cumulative steroid exposure vs ONFH incidence | Post-transplant recipients in cited evidence | 6% (≤520 mg), 17% (520–600 mg), 28% (>600 mg) | First 2 weeks post-transplant exposure | Historical dose-response data summarized in ARCO consensus (pqac-00000019) | Yoon 2019, *Journal of Arthroplasty* | https://doi.org/10.1016/j.arth.2018.09.005 |
| Long-term glucocorticoid complication rate | Long-term glucocorticoid users | 5%–40% may develop osteonecrosis | Long-term use | Systematic review on hormone-induced ONFH pathogenesis (pqac-00000012) | Ma 2024, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-024-04748-2 |
| Long-term glucocorticoid skeletal complication rate | Long-term glucocorticoid users | 30%–50% may have fractures | Long-term use | Contextualizes steroid toxicity burden (pqac-00000012) | Ma 2024, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-024-04748-2 |
| Non-traumatic subtype share | Asia, non-traumatic ONFH due to alcohol | 32.4%–45.3% of non-traumatic ONFH | Not specified | Estimate cited in alcohol-focused literature synthesis (pqac-00000013) | Pang 2025, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-025-06138-8 |
| THA utilization | U.S. ONFH patients in summarized 2010–2020 data | 94% underwent joint replacement; THA 88.1% of procedures | 2010–2020 | Reported in alcohol-induced ONFH bibliometric review summarizing U.S. data (pqac-00000013) | Pang 2025, *Journal of Orthopaedic Surgery and Research* | https://doi.org/10.1186/s13018-025-06138-8 |
| End-stage treatment burden | China, ONFH | >80% eventually undergo total joint arthroplasty | Not specified | Reported in endothelial dysfunction review (pqac-00000009) | Shao 2024, *Biomedicines* | https://doi.org/10.3390/biomedicines12030664 |


*Table: This table summarizes quantitative epidemiology, natural history, and exposure-threshold statistics for osteonecrosis/osteonecrosis of the femoral head from the gathered evidence. It is useful for quickly comparing disease burden, progression risk, and major etiologic thresholds across populations and studies.*