Evidence map›Paper›PMID 29619500›Full record

ReviewInternational orthopaedics2018

Early-stage osteonecrosis of the femoral head: where are we and where are we going in year 2018?

Eric Larson, Lynne C Jones, Stuart B Goodman, Kyung-Hoi Koo, Quanjun Cui

Abstract readReview
PubMed Publisher
In one paragraph

Review in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 7 pooled it
16.3field-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

86 citing papers in PubMed, 7 syntheses or guidelines pooled it, 167 citations in OpenAlex.

  1. Pooled it
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  6. Pooled it
  7. Osteonecrosis of the femoral head: genetic basis.International orthopaedics · 2019
    Pooled it
  8. Trial
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  12. Article
  13. Review
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  15. Article
  16. Relaxation Time Mapping of Early-Stage Osteonecrosis of the Femoral Head: An In Vivo Piglet Model Study.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026
    Article
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  18. Article
  19. Article
  20. Review

26 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

5 authors at 4 institutions in 2 countries.

Eric LarsonDepartment of Orthopaedic Surgery, University of Virginia School of Medicine, 400 Ray C. Hunt Drive, Suite 330, Charlottesville, VA, 22903, USA.
Lynne C JonesDepartment of Orthopaedic Surgery, Johns Hopkins School of Medicine, A663 Bayview Medical Campus, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Stuart B GoodmanDepartment of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, 450 Broadway St., M/C 6342, Redwood City, CA, 94063, USA.
Kyung-Hoi KooDepartment of Orthopedic Surgery, Seoul National University, Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, South Korea.
Quanjun CuiDepartment of Orthopaedic Surgery, University of Virginia School of Medicine, 400 Ray C. Hunt Drive, Suite 330, Charlottesville, VA, 22903, USA. qc4q@hscmail.mcc.virginia.edu.ORCID http://orcid.org/0000-0003-4285-4488
University of Virginia · USJohns Hopkins University · USSeoul National University Bundang Hospital · KRStanford Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Osteonecrosis of the femoral head (ONFH) is a devastating condition affecting relatively young patients whereby the femoral head is necrotic, resulting in significant pain, articular surface collapse, and eventual osteoarthritis. This condition has been highly associated with chronic steroid use, alcoholism, and hip trauma, as well as other less common conditions. Without intervention, this condition has a high likelihood of progressing and developing into end-stage osteoarthritis. Unfortunately, ONFH is difficult to diagnose on plain radiographs in the early stages of the disease, and often requires more advanced imaging modalities such as MRI in order to fully assess for early degeneration. Providers, therefore, must have a high index of suspicion when a younger patient presents with hip pain and negative X-rays. Unfortunately, in patients whose femoral heads have already collapsed, joint-preserving procedures are not effective, and total hip arthroplasty remains the most reliable long-term treatment. Multiple treatments have been pursued to address osteonecrosis in patients whose femoral head have not yet collapsed, but the results of these treatments are mixed. The most promising of these interventions to date is core decompression with the use of concentrated bone marrow aspirate to improve the healing potential of the femoral head. Further studies including randomized clinical trials are necessary in order to assess the effectiveness of this therapy, the best possible source of cells and the best method of implantation in order to further improve results in those with pre-collapse ONFH.

Indexed as

Arthroplasty, Replacement, HipDecompression, SurgicalFemur HeadFemur Head NecrosisHumansMaleMesenchymal Stem Cell TransplantationTreatment OutcomeAvascular necrosisCore decompressionFemoral headHipMesenchymal stem cellsOsteonecrosisStem cells

Identifiers

PMID29619500
OpenAlexW2796177570

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.