ABSTRACT

Objectives

The regenerative capabilities of bone marrow-derived cell therapies (BMCTs) have been employed in combination with core decompression (CD) in the management of osteonecrosis of the femoral head to prevent or delay the necessity of total hip arthroplasty.

Methods

The authors conducted a meta-analysis to compare the results of level of evidence I trials comparing CD with and without BMCTs.

Results

Data from 7 RCTs (579 patients) were collected, with. Overall, 579 procedures were analysed: 265 in the CD group and 263 in the CD + BMCTs group. The unpaired t-test found an optimal comparability concerning age and gender, drill size, aetiology and grade of OFNH (P > 0.1) between the two groups. At a mean follow up of 82.29 (24 to 360) months, The VAS scored favourably for the CD + BMCTs group (mean difference: -12.88; 95% CI: -17.13 to -8.63; P < 0.0001), as well the rate of THA (odd ratio: -0.14; 95% CI: -5.99 to 5.60; P < 0.0001). Time to failure (P = 0.4) and to THA (P = 0.9) were similar between the two groups, as was the rate of failure (P = 0.3).

Conclusion

In patients with femoral head osteonecrosis, core decompression combined with BMCTs demonstrated reduced pain and lower rate to total hip arthroplasty compare to core decompression as an isolated procedure.

中文翻译：

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核心减压分离或联合骨髓衍生细胞疗法治疗股骨头坏死

摘要

目标

骨髓源性细胞疗法（BMCT）的再生能力已与核心减压（CD）结合用于股骨头骨坏死的预防或预防全髋关节置换术的必要性。

方法

作者进行了荟萃分析，比较了有无BMCT的CD的I级临床试验结果。

结果

收集了来自7个RCT（579例患者）的数据。总体上，共分析了579个程序：CD组265个，CD + BMCTs组263个。未配对的t检验发现两组之间在年龄和性别，钻头大小，病因和OFNH等级（P> 0.1）方面具有最佳可比性。平均随访82.29（24至360）个月，VAS在CD + BMCTs组中得分良好（平均差异：-12.88； 95％CI：-17.13至-8.63； P <0.0001），且得分高THA（奇数比：-0.14； 95％CI：-5.99至5.60； P <0.0001）。两组的失败时间（P = 0.4）和达到THA的时间（P = 0.9）相似，失败率也一样（P = 0.3）。

结论

与单独的核心减压术相比，在具有股骨头坏死的患者中，核心减压联合BMCTs可以减轻疼痛，降低全髋关节置换术的发生率。