Russian Scientific Center of Surgery Named after Academician B. V. Petrovsky, 121359 Moscow, Russia.
Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, 119435 Moscow, Russia.
Med Sci (Basel). 2024 Jul 2;12(3):32. doi: 10.3390/medsci12030032.
Avascular necrosis (AVN) of the femoral head is a pressing orthopedic issue, leading to bone tissue death due to disrupted blood supply and affecting the quality of life of individuals significantly. This review focuses on conservative treatments, evaluating their efficacy as mainstay therapies. Enhanced understanding of AVN's pathophysiology and advancements in diagnostic tools have rekindled interest in non-surgical interventions, emphasizing personalized, multidisciplinary approaches for improved outcomes.
A systematic search was conducted on PubMed, SCOPUS, and Google Scholar databases from January 2020 to August 2023, with the objective of focusing on conservative treatments for AVN of the femoral head. Eligible studies, including original research, case reports, and observational studies, were examined for relevant, well-documented patient outcomes post-conservative treatments, excluding non-English and surgically focused articles without comparative conservative data.
A systematic search yielded 376 records on AVN of the femoral head across multiple databases. After de-duplication and rigorous screening for relevance and quality, 11 full-text articles were ultimately included for a comprehensive qualitative synthesis, focusing on conservatively managing the condition.
This review evaluates the effectiveness of conservative treatments such as pharmacological interventions and physical modalities in managing AVN of the femoral head. Despite promising results in symptom alleviation and disease progression delay, variability in outcomes and methodological limitations in studies necessitate further rigorous, randomized controlled trials for a robust, patient-centric approach to optimize therapeutic outcomes in AVN management.
股骨头缺血性坏死(AVN)是一个紧迫的骨科问题,由于血液供应中断导致骨组织死亡,显著影响个体的生活质量。本综述重点关注保守治疗,评估其作为主要治疗方法的疗效。对 AVN 病理生理学的深入理解和诊断工具的进步重新激发了对非手术干预的兴趣,强调个性化、多学科方法以获得更好的结果。
我们在 PubMed、SCOPUS 和 Google Scholar 数据库中进行了系统性检索,检索时间为 2020 年 1 月至 2023 年 8 月,旨在关注股骨头缺血性坏死的保守治疗。纳入了包括原始研究、病例报告和观察性研究在内的合格研究,以评估保守治疗后患者的相关、有充分记录的结局,排除非英语文献和没有比较性保守数据的以手术为重点的文章。
在多个数据库中对股骨头缺血性坏死进行系统性检索后得到了 376 条记录。经过去重和严格筛选相关性和质量后,最终纳入 11 篇全文文章进行全面的定性综合分析,重点关注保守治疗该疾病的方法。
本综述评估了药物干预和物理疗法等保守治疗在管理股骨头缺血性坏死中的有效性。尽管在缓解症状和延缓疾病进展方面取得了有希望的结果,但研究结果的变异性和方法学局限性需要进一步进行严格的、随机对照试验,以采用以患者为中心的方法优化 AVN 治疗的治疗结果。