One in five patients require conversion to arthroplasty after non-vascularized bone grafts in patients with osteonecrosis of the femoral head: a systematic review

Journal of Orthopaedic Surgery and Research

Research Article

Guowen Bai¹  Jianxiong Li¹  Liang Mo¹  Zhangzheng Wang¹  Hua Zhang²  Jie Li² 

[1] Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China;

关键词: Meta-analysis;    Osteonecrosis of the femoral head;    Non-vascularized bone graft;    Total hip arthroplasty;    Hip preservation;   

DOI  :  10.1186/s13018-023-03544-8

 received in 2022-12-21, accepted in 2023-01-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundNon-vascularized bone grafting (NVBG) has demonstrated to treat osteonecrosis of the femoral head (ONFH). There are a number of articles updating the use of NVBG to treat the ONFH, but the percentage of patients subsequently undergoing a total hip arthroplasty (THA) is controversial.MethodsSeveral electronic databases, including PubMed, Embase, Web of Science, and Cochrane databases, were searched to find studies using NVBG to treat ONFH. The pooled rate and 95% confidence interval (CI) were used to assess the conversion rate to THA after NVBG. In addition, we performed subgroup, sensitivity, and publication bias analysis.ResultsA total of 37 studies describing 2599 hips were included. The mean weighted follow-up time was 50.5 months and the mean age at surgery was 36.3 years. The conversion rate to THA after NVBG was 21% (95%CI: 17% to 25%), and subgroup analyzes indicated lightbulb, trapdoor and Phemister techniques incidences with THA of 15%, 19%, and 24%, respectively.ConclusionsThis study preliminarily obtained the general trend of the survival rate of NVBG patients, but these results should be interpreted cautiously. Pooled results from 2599 hips and of these nearly 80% with early stage of osteonecrosis, showed that approximately 21% of patients underwent a THA following NVBG. NVBG treatment for patient with ONFH appears to defer or at least delay the need for THA.

【 授权许可】

CC BY   
© The Author(s) 2023

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