Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis
| Autor: | Carlos Tobar, Giulia Merli, Luca Andriolo, Sante Alessandro Altamura, Giuseppe Filardo, Elizaveta Kon |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Arthroplasty Replacement Hip Avascular necrosis Survivorship law.invention 03 medical and health sciences Femoral head 0302 clinical medicine Randomized controlled trial law Femur Head Necrosis Internal medicine Survivorship curve medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Survival analysis 030222 orthopedics business.industry Mesenchymal stem cell medicine.disease Decompression Surgical Survival Analysis Biological Therapy medicine.anatomical_structure Treatment Outcome Meta-analysis Orthopedic surgery Surgery Hip Joint business |
| Zdroj: | International orthopaedics. 42(7) |
| ISSN: | 1432-5195 |
| Popis: | The aim of this study was to document the available evidence on the use of regenerative techniques for the treatment of femoral head osteonecrosis (or avascular necrosis of femoral head, AVN) and to understand their benefit compared to core decompression (CD) alone in avoiding failure and the need for total hip replacement (THR). The search was conducted on three medical electronic databases according to PRISMA guidelines. The studies reporting number and timing of failures were included in a meta-analysis calculating cumulative survivorship with a Kaplan-Mayer curve. Moreover, the results on failures in treatment groups reported in RCT were compared with those documented in control groups, in order to understand the benefit of biological therapies compared to CD for the treatment of AVN. Forty-eight studies were included in this systematic review, reporting results of different types of regenerative techniques: mesenchymal stem cell implantation in the osteonecrotic area, intra-arterial infiltration with mesenchymal stem cells, implantation of bioactive molecules, or platelet-rich plasma. Overall, reported results were good, with a cumulative survivorship of 80% after ten year follow-up, and better results when regenerative treatments were combined to CD compared to CD alone (89.9% vs 70.6%, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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