scholarly journals The Effect of Extracorporeal Shock Wave on Osteonecrosis of Femoral Head: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jin Mei ◽  
Lili Pang ◽  
Yu Gong ◽  
Zhongchao Jiang
Keyword(s):  
Shock Wave ◽  
Femoral Head ◽  
Meta Analysis ◽  
Core Decompression ◽  
Visual Analogue Score ◽  
Harris Hip Score ◽  
Lesion Area ◽  
China National Knowledge Infrastructure ◽  
Osteonecrosis Of Femoral Head ◽  
Extracorporeal Shock Wave

Abstract Background: This study aimed to determine whether ESWT (extracorporeal shock wave therapy) has an efficient effect on ONFH (osteonecrosis of femoral head) in clinical outcomes and radiography outcomes.Method: Two authors independently searched the papers on the treatment of femoral head necrosis with extracorporeal shock wave in CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), CSPD (China Science Periodical Database) , Pubmed, Embase and Springer databases. Search period from the inception dates to June 2, 2020 and have no limitations in language; Two authors independently conducted Quality evaluation and data extraction for included studies and preformed a meta-analysis with data extracted and calculated by using review manager 5.3.Result: Nine articles with 409 patients were included in this meta-analysis. The pooled results of HHS (Harris hip score) in eight studies with 337 hips show that ESWT achieved higher Harris scores compared to before treatment (MD= -19.95;95% CI: -26.27, -13.64;). The differences were statistically significant (p<0.01). The pooled results of VAS (visual analogue score) in seven studies with 253 hips show that ESWT achieved lower VAS compared to baseline (MD= 2.77;95%CI: 1.88, 3.65;), the differences were statistically significant (p<0.01). the pooled results of lesion of MRI with 164 hips show that ESWT decrease the lesion area of MRI (SMD=1.03,CI: 0.75,1.30,),the differences were statistically significant (p<0.01).Conclusion: ESWT have an effect in pain relief and can improve motion function. It's effect better than surgical groups (core decompression and core decompression with bone grafting). But it may not decrease the lesion area of the femoral head on MRI.

Effectiveness and safety of extracorporeal shock wave treatment for low back pain:a systematic review and meta-analysis of RCTs

2020 ◽  
Author(s):  
Jinhui Ma ◽  
Yan Yan ◽  
Bailiang Wang ◽  
Wei Sun ◽  
Debo Yue ◽  
...  
Keyword(s):  
Shock Wave ◽  
Rating Scale ◽  
Meta Analysis ◽  
Post Treatment ◽  
Mean Difference ◽  
Control Group ◽  
Low Back ◽  
China National Knowledge Infrastructure ◽  
Pain Scores ◽  
Extracorporeal Shock Wave

Abstract Background Extracorporeal shock wave therapy (ESWT) has been widely used in musculoskeletal disorders. This meta-analysis was designed to assess the effectiveness and safety of ESWT for patients with low back pain (LBP). Methods Multiple electronic databases including Pubmed, Embase, Cochrane’s library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched until December, 2019 to identify studies assessing the effectiveness and safety of EPSW for LBP. The prime outcome is pain intensity measured by Visual Analog Scale (VAS) or numeric rating scale (NRS). Other outcomes included functional status, quality of life, psychological outcomes measured by Oswestry Disability Index (ODI), as well as the adverse events. Mean differences were calculated for continuous outcomes, while odd ratios were calculated for binary outcomes. Revman 5.3 software was used for statistical analysis. Results Five randomized controlled trials (RCTs) were finally included in this meta-analysis. The pooled mean difference in post-treatment pain scores was −2.37 (P <0.0001), indicating that post-treatment pain scores was significantly higher by 2.37 in control group than in ESWT group. At a mean follow-up time of 4-6 weeks, the pooled mean difference in ODI scores was −14.10 (P <0.00001), indicating that the pooled mean difference of post-treatment ODI scores was 14.10 higher in control group than in ESWT group. Conclusions The use of focused ESWT is effective in alleviating pain and improving the general fuctional state for patients with LBP. However, more evidence was needed to verify its safety.

scholarly journals Autologous Stem Cells Combined Core Decompression for Treatment of Avascular Necrosis of the Femoral Head: A Systematic Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Shibing Xu ◽  
Lei Zhang ◽  
Hongting Jin ◽  
Letian Shan ◽  
Li Zhou ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Core Decompression ◽  
Autologous Bone Marrow ◽  
Bone Marrow Stem Cells ◽  
Harris Hip Score ◽  
Autologous Bone

Objective. This study aims to systematically evaluate the efficacy and safety of core decompression combined transplantation of autologous bone marrow stem cells (CDBMSCs) for treatment of avascular necrosis of the femoral head (ANFH). Methods. Randomized controlled trials (RCTs) regarding effectiveness of core decompression combined transplantation of autologous bone marrow stem cells for treating ANFH were searched in 8 comprehensive databases prior to September 2016. The data analysis was performed by using the RevMan version 5.3. Results. A total of 11 studies with 507 participants were included. Results showed that CDBMSCs group was more effective than CD group in increasing Harris hip score, decreasing necrotic area of femoral head, collapse of femoral head, and conversion to total hip replacement incidence. In the subgroup analysis, the results did not change in different intervention measure substantially. In addition, the safety of CDBMSCs for ANFH is reliable. Conclusion. Based on the systematic review, our findings suggest that core decompression combined transplantation of autologous bone marrow stem cells appeared to be more efficacious in the treatment at early stages of ANFH.

scholarly journals Effect of Platelet-rich Plasma Combined With Core Decompression Bone Grafting for Osteonecrosis of Femoral Head: A Meta-Analysis

2021 ◽  
Author(s):  
QiZhong Lai ◽  
Kaishen Cai ◽  
Tianye Lin ◽  
Peng Yang ◽  
Binglang Xiong ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Bone Grafting ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Core Decompression ◽  
Osteonecrosis Of Femoral Head ◽  
Group A ◽  
Group B ◽  
Better Than

Abstract Objective: Core decompression bone grafting usually is used hip-preserving approach for osteonecrosis of femoral head (ONFH). Platelet-rich plasma (PRP) is an adjuvant therapy, combined with core decompression bone grafting for ONFH. However, it remains controversial. Therefore, its efficacy was systematically evaluated and meta-analysis in this study.Methods: Literature on core decompression bone grafting for ONFH was retrieved in CNKI, Wan Fang, PubMed, Embase, Cochrane Library and Web of Science from inception to March 2021. Review Manager 5.3 software and Stata 12.0 software were used for data synthesis.Results: A total of 10 RCTs were included. The results showed at final follow-up that, Harris hip score was significantly difference in the treatment group, adjuvant therapy with PRP (group A) better than the control group (group B), MD=7.53 [95%CI (5.29,9.77)]，P < 0.00001. There was MD=-0.71[95%CI (-0.96, -0.46)], P < 0.00001, of visual analog scale (VAS) of hip pain between the two groups. The excellent and good rate of function of hip was 1.42-fold higher in group A than that in group B, RR=1.42, 95%CI (1.25,1.62), P<0.00001. The progression and total hip arthroplasty were showed improvements, RR=0.37,95%CI (0.21,0.65), P=0.0006 and RR=0.39,95%CI (0.18,0.85), P=0.02, respectively. Begg's and Egger's tests did not indicate publication bias.Conclusion: It was shown that the use of PRP combined with core decompression bone grafting improved the symptoms better than core decompression bone grafting only, and might delay progression and total hip arthroplasty. However, as the study’s limitations, it needed to be fully verified by more large-sample multicenter prospective clinical studies.

scholarly journals The Top 100 Cited Articles in Osteonecrosis of the Femoral Head: a Bibliometric Analysis

2021 ◽  
Author(s):  
Yumin Zhang ◽  
Yakang Wang ◽  
Juan Chen ◽  
Qianyue Cheng ◽  
Binfei Zhang ◽  
...  
Keyword(s):  
Shock Wave ◽  
Tissue Engineering ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Bibliometric Analysis ◽  
Hip Arthroplasty ◽  
Core Decompression ◽  
Extracorporeal Shock Wave ◽  
The Usa ◽  
China And Japan

Abstract Background: The number of articles of clinical and basic research for osteonecrosis of the femoral head (ONFH) is increasing, to our knowledge, there is still a lack of bibliometric analysis on ONFH articles. The purpose of this study was to identify the top 100 cited (T100) articles related to ONFH research and analyze the characteristics and qualities of these articles.Methods: The T100 articles on ONFH were retrieved from the Web of Science database. The information about each article including citations, titles, authors, journals, countries, institutions, and keywords, was recorded for bibliometric analysis. Results: The T100 articles related to ONFH were mainly published from 1991 to 2010 (n=70), and originated from 24 countries. The USA, China, and Japan were the most productive countries in this regard. The most prolific institution was the University of Pennsylvania from the USA with 6 publications and 742 citations. The most-cited article was published in 1995 by Professor Steinberg ME. The five most frequently occurring keywords were “femoral head”, “osteonecrosis”, “core decompression”, “total hip arthroplasty” and “follow up”. The keywords like "bone tissue engineering" and "extracorporeal shock wave" have emerged in recent years.Conclusions: The USA, China, and Japan contributed greatly in terms of the T100 articles. The outcomes of core decompression and total hip arthroplasty gathered most research interests. In recent years, bone tissue engineering and extracorporeal shock wave have become new trends. However, the mechanism of ONFH is still unclear.

scholarly journals Clinical and Radiological Outcomes of Extracorporeal Shock Wave Therapy in Early-Stage Femoral Head Osteonecrosis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Abdulrahman D. Algarni ◽  
Hassan M. Al Moallem
Keyword(s):  
Shock Wave ◽  
Femoral Head ◽  
Clinical Outcomes ◽  
Treatment Option ◽  
Early Stage ◽  
Extracorporeal Shock Wave Therapy ◽  
Harris Hip Score ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Femoral Head Osteonecrosis

Objective. Femoral head osteonecrosis is a progressive clinical condition with significant morbidity and long-term disability. Several treatment modalities including both surgical and nonsurgical options have been used with variable levels of success. High-energy extracorporeal shock wave therapy is a nonoperative treatment option that has been described for early-stage disease. We aimed to assess the functional and radiological outcomes of extracorporeal shockwave therapy (ESWT) in the treatment of osteonecrosis of the femoral head (ONFH). Methods. Thirty-three hips of 21 patients were included in this study. Adult patients with ONFH of any etiology and in the precollapse stage were included. Clinical (visual analogue scale [VAS] and Harris hip score [HHS]) and radiological (plain radiographs and magnetic resonance imaging [MRI]) evaluations were performed before and after intervention. We used 3000–4500 pulses in a single session performed under general anesthesia. Results. At an average of 8 months after ESWT, pain scores and HHS were significantly improved compared with the preintervention scores (p<0.001). The overall clinical outcomes were improved in 21 hips (63.3%), unchanged in 5 hips (15.15%), and worsened in 7 hips (21.2%). A trend toward a decrease in the size of the ONFH was observed although not of clinical significance (p=0.235). MRI revealed significant resolution of bone marrow edema (p<0.003). Regression was observed in 9 lesions (42.9%) and progression in 1 lesion (4.7%); no change was observed in the remaining 23 lesions (52.4%). Conclusion. ESWT is a viable noninvasive treatment option for early-stage ONFH. It significantly improves clinical outcomes and may halt or delay the radiographic progression of the disease in the precollapse stage.

scholarly journals High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Fuqiang Gao ◽  
Wei Sun ◽  
Zirong Li ◽  
Wanshou Guo ◽  
Weiguo Wang ◽  
...  
Keyword(s):  
Shock Wave ◽  
Femoral Head ◽  
Early Stage ◽  
Case Series ◽  
Extracorporeal Shock Wave Therapy ◽  
High Energy ◽  
Lesion Size ◽  
Harris Hip Score ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips) were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips) demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score,P=0.00006; Harris hip score,P=0.00091). During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group). The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group,P=0.091; non-LPFH group,P=0.087). A significant reduction in bone marrow edema was observed after treatment (LPFH group,P=0.007; non-LPFH group,P=0.016). High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

scholarly journals The Top 100 Cited Articles in Osteonecrosis of the Femoral Head: A Bibliometric Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yumin Zhang ◽  
Yakang Wang ◽  
Juan Chen ◽  
Qianyue Cheng ◽  
Binfei Zhang ◽  
...  
Keyword(s):  
Shock Wave ◽  
Tissue Engineering ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Bibliometric Analysis ◽  
Hip Arthroplasty ◽  
Core Decompression ◽  
Extracorporeal Shock Wave ◽  
The Usa ◽  
China And Japan

Background. The number of articles of clinical and basic research for osteonecrosis of the femoral head (ONFH) is increasing, yet, to our knowledge, there is still a lack of bibliometric analysis on ONFH articles. The purpose of this study was to identify the top 100 cited (T100) articles related to ONFH research and to analyze the characteristics and qualities of these articles. Methods. The T100 articles on ONFH were retrieved from the Web of Science database. The information about each article including citations, titles, authors, journals, countries, institutions, and keywords was recorded for bibliometric analysis. Results. The T100 articles related to ONFH were mainly published from 1991 to 2010 ( n = 70 ) and were originated from 24 countries. The USA, China, and Japan were the most productive countries in this regard. The most prolific institution was the University of Pennsylvania from the USA with 6 publications and 742 citations. The most cited article was published in 1995 by Professor Steinberg ME. The five most frequently occurring keywords were “femoral head,” “osteonecrosis,” “core decompression,” “total hip arthroplasty,” and “follow up.” The keywords like “bone tissue engineering” and “extracorporeal shock wave” have emerged in recent years. Conclusions. The USA, China, and Japan contributed greatly in terms of the T100 articles. The outcomes of core decompression and total hip arthroplasty gathered the most research interests. In recent years, bone tissue engineering and extracorporeal shock wave have become new trends. However, the mechanism of ONFH is still unclear.

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