■股骨头坏死(ONFH)被认为是一种普遍的,具有挑战性的骨科条件的患者。
■本研究旨在评估各种干预措施对非创伤性ONFH的疗效,并为临床决策者提供指导。
■我们搜索了PubMed,Embase,科克伦图书馆,和WebofScience数据库从开始到2023年2月,用于评估股骨头坏死治疗的相关随机对照试验,没有语言限制。使用Cochrane偏差风险评估工具进行质量评估,并使用Stata15.1进行分析。
■本研究包括11项随机对照试验。荟萃分析结果显示,CellTherapy[MD=-3.46,95CI=(-5.06,-1.85)],InjectableMed[MD=-3.68,95CI=(-6.11,-1.21)],ESWT[MD=-2.84,95CI=(-4.23,-1.45)],ESWT+InjectableMed[MD=-3.86,95CI=(-6.22,-1.53)]在改善VAS疼痛评分方面明显优于CD+PTRI,以及CD+BG+细胞治疗,CD+BG此外,CD+BG+细胞疗法优于CD+BG[MD=-0.97,95CI=(-1.71,-0.19)]。SUCRA对HHS评分的排名表明,CellTherapy(77%)的有效率最好,其次是ESWT+InjectableMed(72.2%),ESWT(58.3%),注射治疗(50%),CD+PTRI(31.4%),和CD+BG(11%)。就WOMAC和Lequesne得分而言,荟萃分析显示,实验组CD+BG+CellTherapy与对照组CD+BG之间无统计学差异。
■CellTherapy和非手术ESWT结合药物或CellTherapy对ONFH的效果最好。手术CD+BG联合CellTherapy比单独CD+BG更有效。ESWT+InjectableMed推荐用于短期或急性发作患者,而ESWT建议用于长期患者。
■https://www.crd.约克。AC.英国/PROSPERO,标识符CRD42024540122。
UNASSIGNED: Osteonecrosis of the femoral head (ONFH) is acknowledged as a prevalent, challenging orthopedic condition for patients.
UNASSIGNED: This study aimed to evaluate the efficacy of various interventions for non-traumatic ONFH and provide guidance for clinical decision-makers.
UNASSIGNED: We searched PubMed, Embase, Cochrane Library, and Web of Science databases from inception to February 2023 for relevant randomized controlled trials evaluating treatments for femoral head necrosis, without language restrictions. Quality evaluation was performed using the Cochrane risk-of-bias assessment tool, and analysis was performed using Stata 15.1.
UNASSIGNED: Eleven randomized controlled trials were included in this study. The meta-analysis results revealed that CellTherapy [MD= -3.46, 95%CI= (-5.06, -1.85)], InjectableMed [MD= -3.68, 95%CI= (-6.11, -1.21)], ESWT [MD= -2.84, 95%CI= (-4.23, -1.45)], ESWT+InjectableMed [MD= -3.86, 95%CI= (-6.22, -1.53)] were significantly more effective in improving VAS pain score than CD+PTRI, as well as CD+BG+CellTherapy, and CD+BG. Furthermore, CD+BG+CellTherapy was better than CD+BG [MD= -0.97, 95%CI= (-1.71, -0.19)]. The SUCRA ranking for HHS score indicated that CellTherapy (77%) has the best effectiveness rate, followed by ESWT+InjectableMed (72.2%), ESWT (58.3%), InjectableMed (50%), CD+PTRI (31.4%), and CD+BG (11%). In terms of WOMAC and Lequesne scores, the meta-analysis showed no statistically significant differences between the experimental group CD+BG+CellTherapy and the control group CD+BG.
UNASSIGNED: CellTherapy and non-surgical ESWT combined with medication or CellTherapy have the best effect on ONFH. Surgical CD+BG combined with CellTherapy is more effective than CD+BG alone. ESWT+InjectableMed is recommended for short-term or acute onset patients, while ESWT is recommended for long-term patients.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024540122.