Evidence map›Paper›PMID 29744647›Full record

Trial reportInternational orthopaedics2018

Cell therapy versus simultaneous contralateral decompression in symptomatic corticosteroid osteonecrosis: a thirty year follow-up prospective randomized study of one hundred and twenty five adult patients.

Philippe Hernigou, Arnaud Dubory, Yasuhiro Homma, Isaac Guissou, Charles Henri Flouzat Lachaniette, Nathalie Chevallier, Hélène Rouard

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 12 pooled it
11.5field-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

87 citing papers in PubMed, 12 syntheses or guidelines pooled it, 145 citations in OpenAlex.

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27 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

7 authors at 1 institution in 1 country.

Philippe HernigouHôpital Henri Mondor, 94010, Creteil, France. philippe.hernigou@wanadoo.fr.
Arnaud DuboryHôpital Henri Mondor, 94010, Creteil, France.
Yasuhiro HommaHôpital Henri Mondor, 94010, Creteil, France.
Isaac GuissouHôpital Henri Mondor, 94010, Creteil, France.
Charles Henri Flouzat LachanietteHôpital Henri Mondor, 94010, Creteil, France.
Nathalie ChevallierHôpital Henri Mondor, 94010, Creteil, France.
Hélène RouardHôpital Henri Mondor, 94010, Creteil, France.
Centre Hospitalier Universitaire Henri-Mondor · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSymptomatic osteonecrosis related to corticosteroids has a high risk of progression to collapse in absence of treatment. The purposes of this study were to evaluate the results of autologous bone marrow grafting of the symptomatic hip in adult patients with osteonecrosis and to compare the results with core decompression alone in the contralateral symptomatic hip. MATERIALS AND

methodsA total of 125 consecutive patients (78 males and 47 females) with bilateral osteonecrosis (ON) and who had both hips symptomatic and at the same stage on each side (stage I or II) were included in this study from 1988 to 1998. The volume of osteonecrosis was measured with MRI in both hips; the smaller size ON was treated with core decompression, and the contralateral hip with the larger ON was treated with percutaneous mesenchymal cell (MSC) injection obtained from bone marrow concentration. The average total number of MSCs (counted as number of colony forming units-fibroblast) injected in each hip was 90,000 ± 25,000 cells (range 45,000 to 180,000 cells).

resultsAt the most recent FU (average 25 years after the first surgery, range 20 to 30 years), among the 250 hips included in the study, 35 hips (28%) had collapsed at the most recent follow-up after bone marrow grafting, and 90 (72%) after core decompression (CD). Ninety-five hips (76%) in the CD group underwent total hip replacement and 30 hips (24%) in the bone marrow graft group (p < 0.0001). Hips undergoing only CD were approximately three times more likely to undergo a primary THA (odds ratio: 10.0278; 95% CI: 5.6117 to 17.9190; p < 0.0001) as compared with hips undergoing an initial bone marrow grafting. For the 90 hips treated with bone marrow injection and without collapse, the mean volume of repair evaluated by MRI at the most recent follow-up was 16.4 cm

conclusionCore decompression with bone marrow injection improved the outcome of the disease as compared with core decompression alone in the same patient.

Indexed as

AdolescentAdultArthroplasty, Replacement, HipCombined Modality TherapyDecompression, SurgicalFemaleFemur Head NecrosisFollow-Up StudiesGlucocorticoidsHip JointHumansMagnetic Resonance ImagingMaleMesenchymal Stem Cell TransplantationMiddle AgedProspective StudiesGlucocorticoidsBone marrowCell therapyCore decompressionCorticosteroidsHip osteonecrosisMesenchymal stem cell

Identifiers

PMID29744647
OpenAlexW2801648250

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.