Purpose: The purpose of this review was to conduct a literature search assessing the efficacy of various conservative treatments of BMES. Methods: According to the PRISMA guidelines, a literature search was conducted in April 2021 in MEDLINE database via PubMed and Embase to identify original articles describing the results of conservative treatments for BMES of hip and knee published in the last ten years. For each study, information regarding study characteristics, description of the treatment, patient's demographic and clinical data, length of follow-up, clinical outcome measure, disability, adverse events, classification, and extent and of edema on MRI, were extracted. Results: A total of 12 studies were identified. Two studies described treatment with iloprost, three with hyperbaric oxygen (HBO), two with bisphosphonates, five with extracorporeal shockwave therapy (ESWT). The total number of patients was 351: 34 treated with iloprost, 64 with hyperbaric oxygen, 37 with bisphosphonates, 216 with ESWT. In ESWT studies, treatment with a higher flux density and a higher number of therapy sessions lead to better clinical and radiological scores. In iloprost studies, a more remarkable improvement in the VAS scale was observed in the study on hip patients. Conclusions: The treatment of idiopathic bone marrow edema is currently not standardized, making it difficult to find data that can be compared in a highly reliable way. The studies available in the literature show promising results as for the possibility to cure bone marrow edema efficiently. Standardized radiological scores for evaluating bone marrow edema area are needed in future studies.

目的：本综述的目的是进行文献检索，评估各种 BMES 保守治疗的疗效。方法：根据 PRISMA 指南，于 2021 年 4 月通过 PubMed 和 Embase 在 MEDLINE 数据库中进行文献检索，以找出描述过去十年发表的髋膝关节 BMES 保守治疗结果的原始文章。对于每项研究，提取了有关研究特征、治疗描述、患者的人口统计学和临床​​数据、随访时间、临床结果测量、残疾、不良事件、分类以及 MRI 水肿程度和水肿程度的信息。结果：共确定了 12 项研究。两项研究描述了伊洛前列素的治疗，三个高压氧(HBO)，两个双膦酸盐，五个体外冲击波疗法 (ESWT)。患者总数为 351 人：34 人接受伊洛前列素治疗，64 人接受高压氧治疗，37 人接受双膦酸盐治疗，216 人接受 ESWT。在 ESWT 研究中，更高的通量密度和更多的治疗疗程会导致更好的临床和放射学评分。在伊洛前列素研究中，在髋关节患者的研究中观察到 VAS 量表有更显着的改善。结论：特发性骨髓水肿的治疗目前还没有标准化，因此很难找到可以以高度可靠的方式进行比较的数据。文献中可用的研究显示了关于有效治愈骨髓水肿的可能性的有希望的结果。未来的研究需要用于评估骨髓水肿面积的标准化放射学评分。