股骨头坏死两种治疗方法的有效性比较Meta分析

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Abstract Objective To evaluate the efficacy of treating osteonecrosis of the femoral head(ONFH) with femoral head decompression combined with platelet-rich plasma and with femoral decompression alone.Methods Randomized clinical controlled trials (RCTs) which compared the therapeutic effects between femoral head decompression and platelet-rich plasma combined with surgery in both native and foreign language databases from inception to March 15, 2019 were retrieved from such databases as PubMed, Cochrane Library, CNKI and VIP. Related information was obtained and the quality of the study was evaluated.RevMan software was used for meta-analysis.Results Six studies involving 266 patients (307 hips) were included in this paper.There were 156 hips in the PRP group and 151 hips in the control group. The result of meta-analysis showed that compared with simple femoral head decompression, platelet-rich plasma combined with femoral head decompression could improve hip function Harris score MD=8.65[95%CI (7.12,10.18)]. The excellent rate of Harris score was increased OR=5.09[95%CI (2.40,10.80)]while the postoperative VAS score was reduced MD=-0.47[95%CI (-0.69,-0.25)], so was the disease progression rate OR=0.19[95%CI (0.06,0.57)]. There was statistically significant difference between the two groups.Conclusions Compared with simple femoral head decompression, platelet-rich plasma combined with femoral head decompression for femoral head osteonecrosis can achieve better clinical results.

Key words： platelet-rich plasma osteonecrosis of the femoral head femoral decompression Meta-analysis

Received: 01 April 2019

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	Articles by authors
	YANG Kairui
	DONG Hui
	YANG Yang
	WANG Kai
	XING Jian
	and XIA Qun

Cite this article:

YANG Kairui,DONG Hui,YANG Yang等. Meta-analysis of efficacy of two different approaches to femoral head decompression[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(10): 861-865.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2019/V30/I10/861

[1]	Plancher K D, Razi A. Management of osteonecrosis of the femoral head[J]. Orthop Clin N Am, 1997, 28(3): 461-477.
[2]	Shah K N, Racine J, Jones L C, et al. Pathophysiology and risk factors for osteonecrosis[J]. Curr Rev Musculoskelet Med, 2015, 8(3): 201-209.
[3]	Quanjun C, Botchwey E A. Emerging ideas: treatment of precollapse osteonecrosis using stem cells and growth factors[J]. Clin Orthop Relat Res, 2011, 469(9): 2665-2669.
[4]	Lee E Y, Yun J L. Glucocorticoids as an etiologic factor[M]. Berlin: Springer, 2014: 204-205.
[5]	Anna C R, Quanjun C. Osteonecrosis of the femoral head[J]. Orthop Clin N Am, 2019, 50(2): 139-149.
[6]	Larson E, Jones L C, Goodman S B, et al. Early stage osteonecrosis of the femoral head: where are we and where are we going in year 2018?[J]. Int Orthop, 2018, 42(Suppl 1): 1-6.
[7]	韦标方,韦伟. 高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死[J].中华骨科杂志,2014, 34(7): 777-782.
[8]	None. Guideline for diagnostic and treatment of osteonecrosis of the femoral head[J]. Orthop Surg, 2015, 7(3): 200-207.
[9]	Roth A, Beckmann J, Bohndorf K, et al. S3 Guideline non-traumatic adult femoral head necrosis[J]. Arch Orthop Traum Surg, 2015, 136(2): 165-174.
[10]	Sánchez A R, Sheridan P J, Kupp L I. Is platelet-rich plasma the perfect enhancement factor? A current review[J]. Int J Oral Max Impl, 2015, 18(1): 93-103.
[11]	张长青, 袁霆. 富血小板血浆促进骨缺损修复的实验研究[J]. 中国修复重建外科杂志,2003, 17(5): 355-358.
[12]	Han Y, Huang H, Pan J, et al. Meta-analysis comparing platelet-rich plasma vs hyaluronic acid injection in patients with knee osteoarthritis[J]. Pain Med, 2019, 24(3): 1-12.
[13]	Connell B O, Wragg N M, Wilson S L. The use of PRP injections in the management of knee osteoarthritis[J]. Cell and Tissue Res, 2019, 376(2): 143-152.
[14]	刘松. 富血小板血浆治疗围塌陷期股骨头坏死临床疗效观察及及相关实验研究[D].广州:广州中医药大学, 2018.
[15]	姜良斌, 刘松. 富血小板血浆联合钻孔减压、同种异体腓骨支撑治疗早期股骨头坏死的研究[J]. 中国临床解剖学杂志, 2018, 36(1): 93-97.
[16]	姜良斌. 富血小板血浆联合高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死的研究[J]. 中国临床解剖学杂志, 2018, 36(4): 449-452.
[17]	朱晓龙, 邹德宝. 富血小板血浆联合头颈开窗髂骨植骨治疗股骨头坏死的临床研究[J]. 中国中医骨伤科杂志, 2018, 26(10): 36-39,44.
[18]	杨富强, 杨晓明. 髓芯减压植骨联合富血小板血浆治疗股骨头缺血性坏死的前瞻随机对照研究[J]. 中华关节外科杂志(电子版), 2016, 10(2): 22-25.
[19]	赵程锦, 冯阳阳. 髓芯减压植骨术结合富血小板血浆治疗股骨头缺血性坏死的疗效及术后并发症临床观察[J]. 中国临床研究, 2017, 30(7): 878-882.
[20]	Ando W, Yamamoto K, Koyama T, et al. Radiologic and clinical features of misdiagnosed idiopathic osteonecrosis of the femoral head[J]. Orthop, 2016, 40(1): e117-e123.
[21]	Kubo T, Ueshima K, Saito M, et al. Clinical and basic research on steroid induced osteonecrosis of the femoral head in Japan[J]. J Orthop Sci, 2016, 21(4): 407-413.
[22]	Dick V D J, Lipalo M, Jurek P, et al. Osteonecrosis of the femoral head: evaluation and treatment[J]. J Am Acad Orthop Surg, 2015, 23(2): 69-70.
[23]	Choi H R, Steinberg M E, Cheng E Y. Osteonecrosis of the femoral head: diagnosis and classification systems[J]. Curr Rev Musculoskeletal Med, 2015, 8(3): 1-11.
[24]	Pierce T P, Jauregui J J, Cherian J J, et al. Imaging evaluation of patients with osteonecrosis of the femoral head[J]. Curr Rev Musculoskeletal Med, 2015, 8(3): 221-227.
[25]	Banerjee S, Issa K, Pivec R, et al. Osteonecrosis of the hip: treatment options and outcomes[J]. Orthop Clin N Am, 2013, 44(4): 463-476.
[26]	Pierce T P, Jauregui J J, Elmallah R K, et al. A current review of core decompression in the treatment of osteonecrosis of the femoral head[J]. Curr Rev Musculoskeletal Med, 2015, 8(3): 1-5.
[27]	Mont M A, Jones L C, Hungerford D S. Nontraumatic osteonecrosis of the femoral head: ten years later[J]. J Bone Joint Surg Am, 2006, 88(5): 1117-1132.
[28]	Pepke W, Kasten P, Beckmann N A, et al. Core decompression and autologous bone marrow concentrate for treatment of femoral head osteonecrosis: a randomized prospective study[J]. Orthop Rev, 2016, 8(1): 6162.