Subchondral insufficiency fracture of the femoral head in males

Objective: Subchondral insufficiency fracture of the femoral head (SIF) has been reported to be observed mainly in the elderly osteoporotic females and most of the studies on SIF have been made based on female patients. The purpose of this study is to document the clinical characteristics of SIF observed in male patients. Patients and methods: Between 2001 and 2011, we have diagnosed 39 consecutive SIF hips in our department, based on imaging studies and/or histologic examinations. Among them, 14 hips (35.8 %) were of male SIF patients. Their clinico-radiological characteristics were reviewed. Results: The age range in male SIF patients was 16-62 (ave. 44 years), while that in females was 22-84 (ave. 66 years) (p < 0.001). In male patients, 12 out of 14 hips (86 %) healed by non-surgical treatments, while 2 hips (14 %) underwent surgical treatments (one case: total hip arthroplasty, and one: anterior rotational osteotomy). On the other hand, in female patients 12 out of 25 (48 %) healed, while surgical treatments and/or progression of a collapse were observed in 13 hips (52 %) (p < 0.05). Both body mass index and bone mineral density showed no significant difference between male and female SIF patients. Conclusions: SIF in male is observed mainly in their 40s, and their prognosis seems to be good as compared to that in females.