The outcome of arthroscopic surgery in young adults and adults with osteonecrosis: A systematic review and meta-analysis

Abstract

Avascular necrosis of the femoral head affects active young adults between 30-40 years with the risk of progressing to disabling osteoarthritis. Total hip replacement adds more burden to the disease. The role of arthroscopy is to salvage the hip joint at an earlier stage to minimize surgery. The purpose of this review is to explore the efficacy of arthroscopy to salvage hip joints and minimize surgery. A systematic review of the eminent medical databases including PubMed, Embase, Web of Science, and Scopus were searching for the outcome of arthroscopy in cases of avascular necrosis of the femoral head. The extracted data included English literature from 2000 to the current with the age range18 to 70 years. Case studies, general reviews, operative descriptions were excluded. Meta-analysis was performed for the outcomes including age at the surgery, follow-up duration, Harris Hip Score, and conversion to total hip arthroplasty. The random-effect model was used, and heterogeneity was assessed by Tau2 and I2 statistics taking P value less than 0.05 as a significance level. Only four studies out of 173 research results were considered eligible. The mean age of the participants was 36.27 ±5.03 with a follow-up duration of 63.88 ± 9.68 years. The overall proportion of the operated joints not converted to THA was 0.93 ± 0.04 (P