Evidence map›Paper›PMID 29411077›Full record

SynthesisInternational orthopaedics2018

Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis.

Luca Andriolo, Giulia Merli, Carlos Tobar, Sante Alessandro Altamura, Elizaveta Kon, Giuseppe Filardo

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 45 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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

45 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
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  8. Osteonecrosis of the femoral head: genetic basis.International orthopaedics · 2019
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  14. Comparison of epoprostenol andHistology and histopathology · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Luca AndrioloII Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy.
Giulia MerliNano-Biotechnology Laboratory-NaBi, Research and Innovation Technology Department, Bologna, Italy. giuliamerli85@gmail.com.ORCID http://orcid.org/0000-0001-7895-5606
Carlos TobarDepartment of Orthopedics and Traumatology, Avansalud Clinic of Santiago, Santiago, Chile.
Sante Alessandro AltamuraII Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy.
Elizaveta KonHumanitas University Department of Biomedical Sciences, Milan, Italy.
Giuseppe FilardoNano-Biotechnology Laboratory-NaBi, Research and Innovation Technology Department, Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was to document the available evidence on the use of regenerative techniques for the treatment of femoral head osteonecrosis (or avascular necrosis of femoral head, AVN) and to understand their benefit compared to core decompression (CD) alone in avoiding failure and the need for total hip replacement (THR).

methodsThe search was conducted on three medical electronic databases according to PRISMA guidelines. The studies reporting number and timing of failures were included in a meta-analysis calculating cumulative survivorship with a Kaplan-Mayer curve. Moreover, the results on failures in treatment groups reported in RCT were compared with those documented in control groups, in order to understand the benefit of biological therapies compared to CD for the treatment of AVN.

resultsForty-eight studies were included in this systematic review, reporting results of different types of regenerative techniques: mesenchymal stem cell implantation in the osteonecrotic area, intra-arterial infiltration with mesenchymal stem cells, implantation of bioactive molecules, or platelet-rich plasma. Overall, reported results were good, with a cumulative survivorship of 80% after ten year follow-up, and better results when regenerative treatments were combined to CD compared to CD alone (89.9% vs 70.6%, p < 0.0001).

conclusionRegenerative therapies offer good clinical results for the treatment of AVN. The combination of CD with regenerative techniques provides a significant improvement in terms of survivorship over time compared with CD alone. Further studies are needed to identify the best procedure and the most suitable patients to benefit from regenerative treatments for AVN.

Indexed as

Arthroplasty, Replacement, HipBiological TherapyDecompression, SurgicalFemur Head NecrosisHip JointHumansSurvival AnalysisSurvivorshipTreatment OutcomeAvascular necrosis of femoral headBiological therapiesCore decompressionHipOsteonecrosisRegenerative therapies

Identifiers

PMID29411077

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.