Core decompression versus nonoperative management for osteonecrosis of the hip
Core decompression versus nonoperative management for osteonecrosis of the hip
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DOI：
10.1097/00003086-199603000-00020
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发表时间：
1996-03-01
影响因子：
4.2
通讯作者：
Fairbank, AC
中科院分区：
文献类型：
--
作者：
Mont, MA;Carbone, JJ;Fairbank, AC
对文献的全面回顾显示，有42份报告涉及2025个髋关节，（1206例髋关节）或非手术治疗（819例髋关节），不包括电刺激，用于股骨头坏死，同行评审的已发表报告包括一般调查、前瞻性研究和多中心研究，但排除了病例报告，在24项髓芯减压研究中，63.5%的髋关节报告了满意的临床结果，在21项非手术治疗研究中，22.7%的髋关节报告了满意的临床结果。当仅观察塌陷前髋关节时，分别有71%和34.5%的良好结果，重新计算，不包括进行最多核心分解的4个中心的报告（并报告最佳结果）显示，髓芯减压的临床成功率为53%，而非手术治疗组为22.7%，多项研究的研究者报告称，非手术治疗导致极差的结果，据报道，核心减压对股骨头坏死早期阶段的自然史和临床进展有显着影响，鉴于该数据的局限性，只能通过大型前瞻性随机研究来进一步阐明这种影响。
A complete review of the literature disclosed that there were 42 reports of 2025 hips treated by either core decompression (1206 hips) or nonoperative management (819 hips), excluding electrical stimulation, for osteonecrosis of the femoral head, The peer-reviewed published reports included general surveys, prospective studies, and multicenter studies, but excluded case reports, Satisfactory clinical results were reported in 63.5% of hips in 24 studies of core decompression and in 22.7% of hips in 21 studies of nonoperative management, When looking at only precollapse hips, there were 71% versus 34.5% good results, respectively, Recalculation excluding reports by the 4 centers that do the most core decompressions (and report the best results) showed a clinical success rate for core decompression of 53% versus 22.7% for the nonoperatively treated group, Investigators of multiple studies have reported that nonoperative management leads to extremely poor results, Core decompression has been reported to have a notable effect on the natural history and clinical progression in early stages of osteonecrosis of the femoral head, In view of the limitations of this data, further clarification of this effect only can be obtained by large prospective randomized studies.