Orthopedic Injury College, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Joint Orthopedics, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China.
Front Endocrinol (Lausanne). 2024 Aug 21;15:1428125. doi: 10.3389/fendo.2024.1428125. eCollection 2024.
Osteonecrosis of the femoral head (ONFH) is acknowledged as a prevalent, challenging orthopedic condition for patients.
This study aimed to evaluate the efficacy of various interventions for non-traumatic ONFH and provide guidance for clinical decision-makers.
We searched PubMed, Embase, Cochrane Library, and Web of Science databases from inception to February 2023 for relevant randomized controlled trials evaluating treatments for femoral head necrosis, without language restrictions. Quality evaluation was performed using the Cochrane risk-of-bias assessment tool, and analysis was performed using Stata 15.1.
Eleven randomized controlled trials were included in this study. The meta-analysis results revealed that CellTherapy [MD= -3.46, 95%CI= (-5.06, -1.85)], InjectableMed [MD= -3.68, 95%CI= (-6.11, -1.21)], ESWT [MD= -2.84, 95%CI= (-4.23, -1.45)], ESWT+InjectableMed [MD= -3.86, 95%CI= (-6.22, -1.53)] were significantly more effective in improving VAS pain score than CD+PTRI, as well as CD+BG+CellTherapy, and CD+BG. Furthermore, CD+BG+CellTherapy was better than CD+BG [MD= -0.97, 95%CI= (-1.71, -0.19)]. The SUCRA ranking for HHS score indicated that CellTherapy (77%) has the best effectiveness rate, followed by ESWT+InjectableMed (72.2%), ESWT (58.3%), InjectableMed (50%), CD+PTRI (31.4%), and CD+BG (11%). In terms of WOMAC and Lequesne scores, the meta-analysis showed no statistically significant differences between the experimental group CD+BG+CellTherapy and the control group CD+BG.
CellTherapy and non-surgical ESWT combined with medication or CellTherapy have the best effect on ONFH. Surgical CD+BG combined with CellTherapy is more effective than CD+BG alone. ESWT+InjectableMed is recommended for short-term or acute onset patients, while ESWT is recommended for long-term patients.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024540122.
股骨头坏死（ONFH）被认为是一种普遍存在且具有挑战性的骨科疾病。
本研究旨在评估非创伤性股骨头坏死各种干预措施的疗效，并为临床决策者提供指导。
我们从建库到 2023 年 2 月在 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库中检索评估股骨头坏死治疗的随机对照试验，不限制语言。使用 Cochrane 偏倚风险评估工具进行质量评估，并使用 Stata 15.1 进行分析。
本研究纳入了 11 项随机对照试验。Meta 分析结果显示，CellTherapy[MD=-3.46，95%CI=(-5.06，-1.85)]、InjectableMed[MD=-3.68，95%CI=(-6.11，-1.21)]、ESWT[MD=-2.84，95%CI=(-4.23，-1.45)]、ESWT+InjectableMed[MD=-3.86，95%CI=(-6.22，-1.53)]在改善 VAS 疼痛评分方面明显优于 CD+PTRI、CD+BG+CellTherapy 和 CD+BG，且 CD+BG+CellTherapy 优于 CD+BG[MD=-0.97，95%CI=(-1.71，-0.19)]。HHS 评分的 SUCRA 排名表明，CellTherapy（77%）的有效率最高，其次是 ESWT+InjectableMed（72.2%）、ESWT（58.3%）、InjectableMed（50%）、CD+PTRI（31.4%）和 CD+BG（11%）。在 WOMAC 和 Lequesne 评分方面，实验 CD+BG+CellTherapy 组与对照 CD+BG 组之间Meta 分析结果无统计学差异。
CellTherapy 和非手术 ESWT 联合药物或 CellTherapy 对 ONFH 效果最佳。手术 CD+BG 联合 CellTherapy 比单独使用 CD+BG 更有效。建议短期或急性发作患者使用 ESWT+InjectableMed，长期患者使用 ESWT。
https://www.crd.york.ac.uk/PROSPERO，标识符 CRD42024540122。
