Background: Osteonecrosis of the femoral head (ONFH) presents major significant clinical challenges and variations in epidemiology across regions, with particularly high prevalence in East Asia. This study updates the trends in prevalence and associated medical costs of ONFH in South Korea from 2013 to 2022, with a focus on the impact of the COVID-19 pandemic.

Methods: We analyzed data from the Health Insurance Review and Assessment (HIRA) database, identifying patients diagnosed with ONFH using specific International Classification of Diseases, 10^th revision (ICD-10) codes. The study excluded individuals under 20 years and calculated both crude and age-adjusted prevalence rates. We also assessed the total and out-of-pocket medical costs associated with ONFH treatment.

Results: From 2013 to 2022, the annual diagnosis of ONFH increased significantly, peaking in 2019 before declining in 2020 and rebounding thereafter. The crude prevalence rose from 74.1 per 100,000 to a peak, then fell during the pandemic, and increased again post-2020. Age-adjusted prevalence remained relatively stable over the study period, despite a slight dip in 2020. Financially, the total medical cost of treating ONFH increased from 26.7 billion Korean Republic won (KRW) to 41.2 billion KRW, with the highest out-of-pocket costs recorded in 2020.

Conclusion: The prevalence of ONFH in South Korea has generally increased over the past decade, with a temporary decrease observed during the COVID-19 pandemic, likely due to reduced healthcare access. Concurrently, medical costs associated with ONFH have risen, reflecting both the increasing number of cases and possibly more complex treatments. The pandemic's impact suggests a need for continuous monitoring of healthcare utilization patterns and cost management in ONFH treatment, especially given the potential long-term effects of COVID-19-related interventions like steroid use.

Keywords: COVID-19; South Korea; medical cost; osteonecrosis of the femoral head; prevalence.

Copyright © 2025. Published by Elsevier Inc.

背景： 股骨头坏死（ONFH）在不同地区临床挑战和流行病学方面存在重大差异，尤其在东亚地区的发病率较高。本研究更新了2013年至2022年期间韩国ONFH的患病率趋势及其相关医疗费用，并重点关注COVID-19大流行的影響。

方法： 我们分析了健康保险审查和评估（HIRA）数据库的数据，通过特定的国际疾病分类第十版（ICD-10）代码识别股骨头坏死患者。研究排除了20岁以下的个体，并计算了粗患病率和年龄调整后的患病率。此外，还评估了ONFH治疗相关的总医疗费用和个人支付部分。

结果： 从2013年到2022年，每年股骨头坏死的诊断显著增加，在2019年达到高峰后在2020年有所下降，并在此之后反弹。粗患病率从每10万人口74.1例上升至峰值，然后在大流行期间下降，自2020年后再次上升。年龄调整后的患病率在整个研究期间相对稳定，尽管在2020年略有下降。在财务方面，治疗股骨头坏死的总医疗费用从韩国元（KRW）267亿增加到412亿，在2020年记录了最高的个人支付部分。

结论： 过去十年中，韩国股骨头坏死的患病率总体上有所增加，在COVID-19大流行期间出现暂时下降，这可能是由于医疗保健访问减少所致。同时，与ONFH相关的医疗费用也上升了，反映了病例数量的增加和可能更复杂的治疗方法。大流行的影響表明需要持续监测ONFH治疗中的医疗服务使用模式和成本管理，特别是考虑到COVID-19相关干预措施（如皮质类固醇使用）可能会产生的长期影响。

关键词： COVID-19；韩国；医疗费用；股骨头坏死；患病率。