Shifting surgical strategies for osteonecrosis of the femoral head: evidence from a nationwide Japanese database

Nationwide data demonstrate a substantial shift in surgical management of ONFH in Japan, with increasing use of THA and declining reliance on joint-preserving procedures, even among younger patients. While arthroplasty has become the dominant treatment modality, careful consideration of long-term outcomes, complication profiles, and patient age remains essential. Integration of large-scale administrative data with detailed clinical and imaging information may further refine optimal treatment strategies for ONFH.