Hyperbaric oxygen therapy in the treatment of osteonecrosis of the femoral head: a review of the current literature - PubMed (original) (raw)
Review
. 2016 May-Jun;43(3):189-99.
- PMID: 27416686
Review
Hyperbaric oxygen therapy in the treatment of osteonecrosis of the femoral head: a review of the current literature
Gunalp Uzun et al. Undersea Hyperb Med. 2016 May-Jun.
Abstract
Objective: To review the current literature on the use of hyperbaric oxygen (HBO₂) therapy in the treatment of osteonecrosis of the femoral head (ONFH).
Search strategy: We searched PubMed, Directory of Open Access Journals (DOAJ), EMBASE, Web of Science, Academic Search Complete, CINAHL and MEDLINE through April 2015. We hand-searched relevant textbooks, conference proceedings and the reference lists of review articles and clinical studies
Study eligibility criteria: Randomized controlled trials (RCT) and observational studies (cohort study, case-control study, case series) that reported the outcome of patients who received HBO₂therapy for ONFH were included. Only English-language articles were included. Study quality was not used as an exclusion criterion.
Study appraisal and synthesis methods: Two authors independently assessed trials for inclusion, extracted data and presented to other authors. Disagreements were resolved by consensus.
Results: We identified eight clinical studies; two randomized controlled trials (RCTs); one historically controlled study; and five case series. The majority of the studies were small-scale, heterogeneous and methodologically weak. In four of the studies HBO₂therapy was combined with other treatment modalities, making it impossible to draw firm conclusions on the specific effects of HBO₂therapy. Hip survivorship in studies wherein HBO₂therapy was used alone was 95.5% in Steinberg Stage I lesions, 89% in Steinberg Stage II lesions and 100% in Ficat Stage II lesions.
Conclusions: There is a room for HBO₂therapy in the management ONFH. Further RCTs, however, are required to better elucidate the role of HBO₂therapy in the treatment of ONFH.
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