Evidence map›Paper›PMID 27298230›Full record

SynthesisBritish medical bulletin2016

Core decompression versus other joint preserving treatments for osteonecrosis of the femoral head: a meta-analysis.

Francesco Sadile, Alessio Bernasconi, Sergio Russo, Nicola Maffulli

Open access · bronzeAbstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British medical bulletin, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
109citing papers in PubMed, 14 pooled it
4.4field-weighted citation impact, top 6% 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

109 citing papers in PubMed, 14 syntheses or guidelines pooled it, 186 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Trial
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article

49 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 2 institutions in 2 countries.

Francesco SadileDepartment of Public Health, Orthopaedic and Traumatology Unit, 'Federico II' Naples University School of Medicine and Surgery, Naples, Italy.
Alessio BernasconiDepartment of Public Health, Orthopaedic and Traumatology Unit, 'Federico II' Naples University School of Medicine and Surgery, Naples, Italy.
Sergio RussoDepartment of Public Health, Orthopaedic and Traumatology Unit, 'Federico II' Naples University School of Medicine and Surgery, Naples, Italy.
Nicola MaffulliDepartment of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentistry, Salerno, Italy Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK n.maffulli@qmul.ac.uk.
Federico II University Hospital · ITQueen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOsteonecrosis of femoral head (ONFH) leads to hip osteoarthritis (HOA); among joint preserving treatments (JPT), the role of core decompression (CD) is still debated. We assessed the efficacy of CD compared with all other JPT in delaying the natural osteonecrosis evolution to HOA. SOURCES OF DATA: Following the PRISMA checklist, the Medline and Scopus databases were searched. Fifteen- to 70-year-old subjects with ONFH with a minimum follow-up of 24 months were considered. The outcomes evaluated were patient clinical status, radiographic progression and total hip arthroplasty (THA) or further surgery (FS) need. Risk ratio (RR) was calculated for every outcome reported. RCT, CCT and prospective studies were included. AREAS OF AGREEMENT: A total of 12 studies (776 patients) met the inclusion criteria. Clinical outcome (RR = 1.14; 95% CI 0.58-2.32; P = 0.05), radiographic progression (RR = 1.64; 95% CI 1.14-2.35; P = 0.05) and the need for THA/FS (RR = 1.52; 95% CI 0.95-2.45; P = 0.05) suggested a slight superiority of other JPT compared with CD. AREAS OF CONTROVERSY: High heterogeneity of the primary investigations was the main limitation of our study. GROWING POINTS: The efficacy and effectiveness of core decompression for ONFH are, at best, no better than other joint preserving strategies. The more recent scientific evidence seems to suggest that such procedure is less successful than other joint preserving strategies. AREAS TIMELY FOR DEVELOPING RESEARCH: Further studies are needed to identify the best therapeutic approach to the ONFH.

Indexed as

Arthroplasty, Replacement, HipDecompression, SurgicalAdolescentAdultAgedControlled Clinical Trials as TopicFemaleFemur Head NecrosisHumansMaleMiddle AgedProspective StudiesRandomized Controlled Trials as TopicTreatment Outcomecore decompressionfemoral headhip osteoarthritisjoint preserving treatmentsosteonecrosis

Identifiers

PMID27298230
PMCPMC5127418
OpenAlexW2408836981

What OpenQuestion holds

Textmetadata
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.