Abstract
PurposeThis article aimed to report a case series of pre-collapse avascular necrosis of the femoral head treated with hyperbaric oxygen and review the most recent literature on the topic.MethodsThe data from a prospectively followed registry of 15 patients with Steinberg I and II avascular necrosis of the femoral head was collected. Functional outcome, pain scores, and radiographic changes at an average follow-up of 22 months were analyzed and reported.ResultsThirteen patients had satisfactory outcome at final follow-up with an average Oxford hip score of 37.3, pain scores were significantly improved at final follow-up (P < 0.001), and 26.7% of hips progressed to collapse on follow-up radiographs with no complications reported in all patients.ConclusionHyperbaric oxygen treatment for pre-collapse avascular necrosis of the femoral head is considered a safe alternative with satisfactory clinical and radiological outcomes and low complications rate.
Highlights
Avascular necrosis (AVN) of the femoral head is not an uncommon pathology with debilitating effects on both patients and health systems
The result was considered statistically significant if P value ≤ 0.05
This study reported the outcome of a series of pre-collapse AVN of the femoral head in 15 consecutive patients treated with Hyperbaric oxygen (HBO)
Summary
Avascular necrosis (AVN) of the femoral head is not an uncommon pathology with debilitating effects on both patients and health systems. Diagnosis and intervention can lift the burden of major surgical intervention such as joint arthroplasty or arthrodesis [1]. Pre-collapse lesions are typically treated with either medical (bisphosphonates) or surgical (core decompression) modalities with good results [2,3,4,5]. Hyperbaric oxygen (HBO) was introduced as a less invasive alternative to surgical interventions for pre-collapse lesions. It is established that HBO improves microcirculation and decreases bone edema, helping in pain relief
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