Clinical efficacy of hyperbaric oxygen treatment on the middle stage steroid-induced necrosis of the femoral head

Abstract

Objective To investigate the clinical efficacy of hyperbaric oxygen (HBO) therapy on steroid-induced necrosis of the femoral head (SNFH) at the stages of ARCOⅡa and Ⅲa. Methods A prospective, randomized, controlled trial was performed in 53 patients (20 were excluded), who were conformed to have SNFH at the stages of ARCOⅡa and Ⅲa through clinical medical care and or hospitalization. Before enrollment, the Harris and MRI scores (the indexes of femoral head necrosis, the areas of necrosis and bone marrow edema) were evaluated in all the subjects. After enrollment, the patients were randomly assigned to the experimental group or the cross group. Before enrollment and after 60 sessions of HBO therapy, the patients in the experimental group were evaluated the second time, which included Harris/MRI scores and relief rate of coxalgia. After 3-month intervention and 6-month HBO therapy, the patients in the cross group had evaluations the second and third times, which also included Harris/MRI scores and relief rate of coxalgia. Results Following HBO therapy, the Harris scores of either the experimental group or the cross group all increased, and the bone marrow edema scores decreased [Before HBO therapy in the experimental group: (68.4±8.2)scores, after HBO thercopy: (76.2±3.6)scores; Before HBO therapy in the cross group: (67.5±4.1)scores; after HBO therapy: (76.1±3.9)scores](P<0.05), while the Harris scores, the area of femoral head necrosis and the bone marrow edema scores all failed to improve in the patients of the cross group (P<0.05). Following HBO therapy, statistical significance could be noted in the relief rate of coxalgia in both groups(P<0.05). Conclusions HBO therapy could improve Harris and MRI scores of the patients at middle stage of steroid-induced necrosis of the femoral head, and could also alleviate coxalgia symptoms of the patients with SNFH. Key words: Steroid-induced necrosis of the femoral head; Middle stage; Hyperbaric oxygen