Prognostic factors in the management of osteonecrosis of the femoral head: A systematic review

Migliorini F, Maffulli N, Baroncini A, Eschweiler J, Tingart M, Betsch M (2022)

Publication Type: Journal article, Review article

Publication year: 2022

Journal

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland Elsevier

DOI: 10.1016/j.surge.2021.12.004

Abstract

Background: Several hip preserving techniques have been described for the management of osteonecrosis of the femoral head (ONFH). This systematic review identified prognostic factors in the treatment of ONFH that are associated with treatment failure and conversion to total hip arthroplasty (THA). Material and methods: This study followed the PRISMA guidelines. The literature search was conducted in November 2021. All clinical trials comparing two or more treatments for femoral head osteonecrosis were accessed. A multivariate analysis was performed to investigate the association between baseline characteristics and the surgical outcome. A multiple linear model regression analysis through the Pearson Product-Moment Correlation Coefficient (r) was used. Results: Data from 88 articles (6112 procedures) were retrieved. Female gender was associated with increased time to THA (P = 0.03) and reduced rate of THA (P = 0.03). Longer symptom duration before treatment was associated with shorter time to failure (P = 0.03). Increased pre-treatment VAS was associated with reduced time to failure (P = 0.03) and time to THA (P = 0.04). Reduced pre-treatment hip function was associated with increased rate of THA (P = 0.02) and failure (P = 0.005). Patient age and BMI, aetiology, time from surgery to full weight bearing and the side did not show evidence of a statistically significant association with the surgical outcome. Conclusion: Male gender, longer symptom duration before treatment, higher VAS scores, and lower HHS scores were negative prognostic factors after treatment for osteonecrosis of the femoral head.

Authors with CRIS profile

Marcel Betsch

Involved external institutions

Universitätsklinikum Aachen (UKA) DE Germany (DE) Università degli Studi di Salerno IT Italy (IT) Universitätsklinikum Mannheim DE Germany (DE)

How to cite

APA:

Migliorini, F., Maffulli, N., Baroncini, A., Eschweiler, J., Tingart, M., & Betsch, M. (2022). Prognostic factors in the management of osteonecrosis of the femoral head: A systematic review. Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. https://dx.doi.org/10.1016/j.surge.2021.12.004

MLA:

Migliorini, Filippo, et al. "Prognostic factors in the management of osteonecrosis of the femoral head: A systematic review." Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland (2022).

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