ReviewClinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases
Aseptic osteonecrosis of the hip in the adult: current evidence on conservative treatment.
Review in Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- The use of extracorporeal shock wave therapy for the treatment of bone marrow oedema - a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2021Pooled it
- Exosome-mediated Piezo1 activation in 3D-printed titanium scaffolds promotes repair of femoral head osteonecrosis.Journal of nanobiotechnology · 2026Article
- Outcomes of the conservative hip preservation treatment in patients with osteonecrosis of the femoral head: With 4-year follow-up.World journal of orthopedics · 2025Article
- Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis.EFORT open reviews · 2025Article
- Astaxanthin as a Potent Antioxidant for Promoting Bone Health: An Up-to-Date Review.Antioxidants (Basel, Switzerland) · 2023Review
- Identification of hub genes and therapeutic drugs in osteonecrosis of the femoral head through integrated bioinformatics analysis and literature mining.Scientific reports · 2023Article
- Core Decompression Prevents Progression of Asymptomatic Type C Osteonecrosis of Femoral Head According to the Japanese Investigation Committee Classification: A Retrospective Study.Orthopaedic surgery · 2022Article
- Osteonecrosis of the Femoral Head.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022Article
- Operative Management of Avascular Necrosis of the Femoral Head in Skeletally Immature Patients: A Systematic Review.Life (Basel, Switzerland) · 2022Review
- Treatment options for secondary osteonecrosis of the knee.Orthopedic reviews · 2022Article
- Recent perspectives on the association between osteonecrosis and bone mineral density decline in childhood acute lymphoblastic leukemia.Faculty reviews · 2021Review
- Huo Xue Tong Luo capsule, a vasoactive herbal formula prevents progression of asymptomatic osteonecrosis of femoral head: A prospective study.Journal of orthopaedic translation · 2019Article
- Multiscale Stem Cell Technologies for Osteonecrosis of the Femoral Head.Stem cells international · 2019Review
- Clinical and Radiological Outcomes of Extracorporeal Shock Wave Therapy in Early-Stage Femoral Head Osteonecrosis.Advances in orthopedics · 2018Article
- Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study.BMC musculoskeletal disorders · 2017Observational
- Epidemiological Profile of Femoral Head Osteonecrosis in the North Indian Population.Indian journal of orthopaedicsArticle
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Treatment of Avascular Osteonecrosis (AVN) of the femoral head to prevent progression to an arthritic hip is a challenging subject. Many conservative treatment options have been proposed in the literature. Weight bearing restriction as a stand-alone therapy is insufficient in preventing disease progression but it may be useful when combined with pharmacological agents or surgery. Bisphosphonate treatment in AVN might be efficient in early stages of disease, however there are no clear recommendations on length of treatment and therapeutic dosage and, considered the limited evidence and potential side effects of treatment, it could be considered in a pre-collapse stage in selected cases. Current literature suggests that low molecular weight heparin could lower disease progression in idiopathic AVN with quality of evidence being very low. Also the evidence to support the use of statins or vasodilators in the treatment of osteonecrosis is very low and their use cannot be recommended. Extracorporeal shock wave therapy may improve pain and function in early stages of disease with a low evidence, but there doesn't seem to be a significant change in time to the occurrence of femoral head collapse. Only one study has been conducted with pulsed electromagnetic fields therefore no recommendation can be given on clinical use of PEF in AVN. Evidence on hyperbaric oxygen therapy in the treatment of AVN is very limited and the high cost of treatment and the limited availability of structures that can provide the service poses other concerns about its feasibility. Based on current evidence, conservative treatment may be considered in early stages of asymptomatic AVN instead of observation only.
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