Failure and progression to total hip arthroplasty among the treatments for femoral head osteonecrosis: a Bayesian network meta-analysis

Author:

Migliorini Filippo1,Maffulli Nicola234,Baroncini Alice1,Eschweiler Jörg1,Tingart Markus1,Betsch Marcel5

Affiliation:

1. Department of Orthopedics and Trauma Surgery, RWTH Aachen University Clinic, 52064 Aachen, Germany

2. Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi SA, Italy

3. Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK

4. School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, ST4 7QB Stoke on Trent, UK

5. Department of Orthopaedics and Trauma Surgery, University Medical Centre Mannheim of the University Heidelberg, 68167 Mannheim, Germany

Abstract

Abstract Introduction Osteonecrosis of the femoral head (ONFH) often leads to secondary osteoarthritis and total hip arthroplasty. Source of data Recent published literatures. Areas of agreement There has been increasing focus on the early intervention in ONFH patients to preserve the native hip articulation, reduce pain and improve function. Areas of controversy Efficacy of surgical strategies for ONFH is debated. Several clinical studies showed controversial results, and the best treatment has not yet been clarified. Growing points To provide an overview over current treatment options for ONFH compares their failure rates and conversion to total hip arthroplasty (THA) rates. Areas timely for developing research Core decompression (CD) augmented with autologous bone grafting plus the implantation of bone marrow concentrate can decrease the rate of failure and progression to THA rates compared to CD alone.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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