TITLE:
Aseptic Femoral Head Osteonecrosis in the Katanga Mining Province in Southeast of Democratic Republic of the Congo
AUTHORS:
Milindi Cédrick Sangwa, Yve Yuma, Mireille Kakinga, Deance Mbayo, Elie Sadoki, Christian Tshisuz, Marc Lumbala, Adelin Muganza, Willy Arung, Celestin Banza, Luc Mokassa
KEYWORDS:
Osteonecrosis, Mining, Katanga
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.15 No.2,
February
11,
2025
ABSTRACT: Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and can be associated with several known risk factors. This study aims to describe these risk factors identified in the former Katanga province, a region with significant mining activity. Method and Patients: This is a descriptive cross-sectional study conducted over a seven-year period (2017-2024), including all cases of aseptic osteonecrosis of the femoral head diagnosed in the orthopedic department of Medpark Clinic in Lubumbashi. The investigation of risk factors was based on the analysis of sociodemographic, clinical, radiological, and biological data. Results: Our study included a total of 110 patients with a mean age of 47.5 years. Among them, there were 46 women (41.82%) and 64 men (58.18%). Twenty-five patients (27.5%) reported a family history of osteonecrosis, and 24% were diagnosed with sickle cell disease. Chronic alcoholism was noted in 14 patients (12.73%), while diabetes was present in 8 (7.2%). Four patients (3.64%) were obese, and three were HIV-positive (2.72%). The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was common, and prolonged corticosteroid use was documented in 5 patients (4.5%). Abnormally high cholesterol levels were found in 26 patients (23.6%). One patient had gout, and two suffered from acute rheumatic fever (1.8%). Regarding inflammatory markers, C-reactive protein levels and erythrocyte sedimentation rates were within normal limits for almost all patients. Electrolyte levels and phosphocalcic profiles showed no abnormalities. Furthermore, 33 patients (30%) did not exhibit any of the previously mentioned risk factors. Most of these patients lived in the regions of Kolwezi, Likasi, and Lubumbashi. Among this group, 25 patients reported performing physically demanding labor, particularly in mining operations. Conclusion: Our study highlighted well-known risk factors for osteonecrosis of the femoral head (ONFH). However, it also identified a significant number of cases without any identifiable risk factors, classified as idiopathic. Among these cases, some patients engaged in intense physical labor, often linked to mining exposure.