Evidence map›Paper›PMID 26220203›Full record

SynthesisActa orthopaedica2016

The role of "cell therapy" in osteonecrosis of the femoral head. A systematic review of the literature and meta-analysis of 7 studies.

Costas Papakostidis, Theodoros H Tosounidis, Elena Jones, Peter V Giannoudis

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta orthopaedica, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 7 pooled it
9.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 7 syntheses or guidelines pooled it, 111 citations in OpenAlex.

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6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Costas Papakostidisa 1 Department of Trauma and Orthopaedics, G. Hatzikostas General Hospital , Ioannina, Greece.
Theodoros H Tosounidisb 2 Academic Department of Trauma and Orthopaedic Surgery, University of Leeds , Leeds.
Elena Jonesc 3 Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds , Leeds.
Peter V Giannoudisb 2 Academic Department of Trauma and Orthopaedic Surgery, University of Leeds , Leeds.
University of Leeds · GBGeneral Hospital of Ioannina G. Hatzikosta · GRNIHR Leeds Musculoskeletal Biomedical Research Unit · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe value of core decrompression for treatment of osteonecrosis of the femoral head (ONFH) is unclear. We investigated by a literature review whether implantation of autologous bone marrow aspirate, containing high concentrations of pluripotent mesenchymal stem cells, into the core decompression track would improve the clinical and radiological results compared with the classical method of core decompression alone. The primary outcomes of interest were structural failure (collapse) of the femoral head and conversion to total hip replacement (THR). PATIENTS AND

methodsAll randomized and non-randomized control trials comparing simple core decompression with autologous bone marrow cell implantation into the femoral head for the treatment of ONFH were considered eligible for inclusion. The methodological quality of the studies included was assessed independently by 2 reviewers using the Cochrane Collaboration tool for assessing risk of bias in randomized studies. Of 496 relevant citations identified, 7 studies formed the basis of this review.

resultsThe pooled estimate of effect size for structural failure of the femoral head favored the cell therapy group, as, in this treatment group, the odds of progression of the femoral head to the collapse stage were reduced by a factor of 5 compared to the CD group (odds ratio (OR) = 0.2, 95% CI: 0.08-0.6; p = 0.02). The respective summarized estimate of effect size yielded halved odds for conversion to THR in the cell therapy group compared to CD group (OR = 0.6, 95% CI: 0.3-1.02; p = 0.06).

interpretationOur findings suggest that implantation of autologous mesenchymal stem cells (MSCs) into the core decompression track, particularly when employed at early (pre-collapse) stages of ONFH, would improve the survivorship of femoral heads and reduce the need for hip arthroplasty.

Indexed as

Arthroplasty, Replacement, HipCell- and Tissue-Based TherapyControlled Clinical Trials as TopicFemaleFemur Head NecrosisHumansIncidenceMaleMesenchymal Stem Cell TransplantationPrognosisRadiographyRandomized Controlled Trials as TopicRisk AssessmentRoleSeverity of Illness IndexTransplantation, Autologous

Identifiers

PMID26220203
PMCPMC4940596
OpenAlexW1950642410

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.